scholarly journals Necrosis and perforation of the stomach in newborn babies and infants

2021 ◽  
Vol 179 (5) ◽  
pp. 36-40
Author(s):  
S. A. Karavaeva ◽  
A. V. Podkamenev ◽  
A. A. Skopetc
Keyword(s):  
Gastric Wall ◽  
Fatal Outcome ◽  
Multiple Organ ◽  
Diagnostic Methods ◽  
Gastric Necrosis ◽  
Extensive Resection ◽  
Organ Volume ◽  
Results Of Treatment ◽  
Atypical Resection ◽  
Extensive Necrosis

The Objective of the study was to identify the clinical features of newborns and infants with perforation of the stomach, and to justify the possibility of organ-preserving operations even with extensive gastric necrosis.Methods and Materials. The results of treatment of 32 newborns with stomach perforation was analyzed: not only the risk factors that cause this condition, but diagnostic methods and variants of surgical treatment. All patients with extensive necrosis of the stomach wall underwent an atypical resection within healthy tissues, a gastric «tube» was formed on the drainage probe with a significant decrease of organ volume. In cases of the local damage of the gastric wall, the perforated area was sutured after the excision of the edges of the defect.Results. Mortality rate was 36.5 % (n = 12). The cause of death in 5 children (15 %), in 3 to 8 days after surgery, was multiple organ failure syndrome. In 7 patients (22 %), a fatal outcome occurred due to the severe post-intensive care syndrome at the age of 3 to 12 months of life.Conclusion. The mechanism of perforations of the stomach in newborns and infants is multifactorial. All children with stomach perforation need preoperative preparation. The operation of choice for the stomach perforation is an organpreserving surgery. The function of the stomach is restored in all children after extensive resection of the stomach. 

scholarly journals Clinical and laboratory characteristics and results of treatment of patients with ACTH-producing neuroendocrine tumors of various localization

2021 ◽  
Vol 93 (10) ◽  
pp. 1171-1178
Author(s):  
Olga O. Golounina ◽  
Zhanna E. Belaya ◽  
Liudmila Ya. Rozhinskaya ◽  
Evgeniya I. Marova ◽  
Michail Yu. Pikunov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fatal Outcome ◽  
Distant Metastases ◽  
Multiple Organ ◽  
Ectopic Acth Syndrome ◽  
Ectopic Acth ◽  
Results Of Treatment ◽  
Single Center Study ◽  
Pancreatic Net

Aim. To study the clinical, biochemical characteristics, treatment results and follow-up of patients with ectopic ACTH syndrome EAS (ACTH adrenocorticotropic hormone ). Materials and methods. A retrospective, observational, single-center study of 130 patients with EAS. Demographic information of patients, medical history, results of laboratory and instrumental investigations at the pre- and postoperative stages and follow-up of EAS were analyzed. Results. The mean age at the diagnosis ranged from 12 to 74 years (Me 40 years [28; 54]). The duration of the disease from the onset of symptoms to the verification of the diagnosis varied from 2 to 168 months (Me 17.5 months [7; 46]). Eighty-one (62,3%) patients had bronchopulmonary NET, 9 thymic carcinoid, 7 pancreatic NET, 5 pheochromocytoma, 1 cecum NET, 1 appendix carcinoid tumor, 1 medullary thyroid cancer and 25 (19.2%) had an occult source of ACTH. The median follow-up period of patients was 27 months [9.75; 61.0] with a maximum follow-up of 372 months. Currently, primary tumor was removed in 82 (63.1%) patients, bilateral adrenalectomy was performed in 23 (18%) patients, in 16 of them there was an occult source of ACTH-producing NET and in 7 patients in order to control hypercortisolism after non-successful surgical treatment. Regional and distant metastases were revealed in 25 (19.2%) patients. At the time of the last observation 59 (72%) patients were exhibited a full recovery, 12 (14.6%) had relapse of the disease and 26 (20%) died from multiple organ failure (n=18), pulmonary embolism (n=4), surgical complications (n=2), disseminated intravascular coagulation syndrome (n=1) or COVID-19 (n=1). Conclusion. In our cohort of patients bronchopulmonary NET are the most frequent cause of EAS (62.3%). Surgical treatment leads to remission of hypercortisolism in 72% cases; the proportion of relapse (14.6%) and fatal outcome (20%) remains frequent in EAS.

scholarly journals Extensive gastric necrosis in an infant

2021 ◽  
Vol 8 (9) ◽  
pp. 2816
Author(s):  
Suraj R. Gandhi ◽  
Neha S. Shenoy ◽  
Vini Joseph ◽  
Apoorva P. Makan ◽  
Syamantak Basu ◽  
...  
Keyword(s):  
Gastric Wall ◽  
Fatal Outcome ◽  
Gastric Volvulus ◽  
Rare Condition ◽  
Abdominal Distension ◽  
Feeding Tube ◽  
Gastric Necrosis ◽  
History Of ◽  
Anterior Gastric Wall ◽  
Upper Abdominal

Gastric necrosis is a rare condition, more so in children and can be potentially fatal. The sloughing of the necrosed wall results in perforations or large defects in the gastric wall.  We report a rare case of extensive gastric necrosis in a 2 months old female infant, managed successfully. Child presented with non-bilious vomiting and excessive cry. There was history of recurrent upper abdominal distension. X-ray of abdomen showed massive pneumoperitoneum. Intra operatively, posterior gastric wall was sloughed off and lower end of feeding tube was lying in the peritoneal cavity. Necrotic wall was debrided and stomach tube was created from remaining anterior gastric wall. Gastrostomy and jejunostomy was done. Post-operative period was uneventful. Dye study at three months showed good gastric capacity. Stomach being a well vascularised organ, necrosis is rare. There is varied etiology of gastric necrosis, volvulus being one of them. Gastric volvulus might be associated with other congenital anomalies like eventration, asplenia, wandering spleen. The incidence of perforation in gastric volvulus with necrosis is 5-28% and a mortality of 50% is reported with such perforations. Vigilant clinical observation in pediatric patients with upper abdominal distension and pain can point the diagnosis and prevent fatal outcome.

POSTOPERATIVE PERICARDIAL EFFUSION SYNDROME

2012 ◽  
pp. 66-71
Author(s):  
Quang Thuu Le
Keyword(s):  
Pericardial Effusion ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Diagnostic Methods ◽  
Open Heart ◽  
Cross Sectional ◽  
Pericardial Drainage ◽  
Results Of Treatment ◽  
Intraoperative Management ◽  
Minimal Problems

Objective: Today, despite many recent improvements in intraoperative management and postoperative care, late pericardial effusions remain an important cause of morbidity after cardiac surgery. Because of widespread use of chronic anticoagulation and increased complexity of operations, the incidence of effusion may be higher. Thus we need to update the information on the symptoms, risk factors, diagnostic methods and treatment of Postoperative pericardial effusion syndrome. Patients and methods: A cross-sectional and prospective study of all patients admitted to hospital because of pericardial effusion after open heart surgery from 1/2010 to 9/2012. Study the clinical characteristics, paraclinicals, evaluate the results of treatment of pericardial effusion after open heart surgery. Results: Symptoms of pericardial effusion are nonspecific. Some patients with pericardial effusion report minimal problems. In the present study, few patients have the classic presentation of tamponade. Echocardiography is the diagnostic accuracy pericardial effusion after open heart surgery. This treatment mainly is pericardial drainage with 100%. Conclusion: Pericardial effusion is a common complication after open-heart surgery, symptoms of pericardial effusion are nonspecific to diagnostic method is echocardiographic surveillance.patients can be treated with internal medicine if has no tamponade and less fliuds. Pericardial drainage is absolute only in patients with pericardial effusion with signs of cardiac tamponade or pericardial many of effusion.

scholarly journals Severe Austrian Syndrome in an Immunocompromised Adult Patient – A Case Report

2018 ◽  
Vol 4 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Ioana Raluca Chirteș ◽  
Dragos Florea ◽  
Carmen Chiriac ◽  
Oana Maria Mărginean ◽  
Cristina Mănășturean ◽  
...  
Keyword(s):  
Case Report ◽  
Streptococcus Pneumoniae ◽  
Histopathological Examination ◽  
Fatal Outcome ◽  
Multiple Organ ◽  
Etiologic Agent ◽  
Acute Meningitis ◽  
History Of ◽  
Valvular Lesions ◽  
Formalin Fixed

AbstractBackground: Known also as Osler’s triad, Austrian syndrome is a complex pathology which consists of pneumonia, meningitis and endocarditis, all caused by the haematogenous dissemination of Streptococcus pneumoniae. The multivalvular lesions are responsible for a severe and potential lethal outcome.Case report: The case of a 51-year-old female patient, with a past medical history of splenectomy, is presented. She developed bronchopneumonia, acute meningitis and infective endocarditis as a result of Streptococcus pneumoniae infection and subsequently developed multiple organ dysfunction syndromes which led to a fatal outcome. Bacteriological tests did not reveal the etiological agent. The histopathological examination showed a severe multivalvular endocarditis, while a PCR based molecular analysis from formalin fixed valvular tissue identified Streptococcus pneumoniae as the etiologic agent.Conclusions: The presented case shows a rare syndrome with a high risk of morbidity and mortality. Following the broad-spectrum treatment and intensive therapeutic support, the patient made unfavourable progress which raised differential diagnosis problems. In this case, the post-mortem diagnosis demonstrated multiple valvular lesions occurred as a result of endocarditis.

scholarly journals Questions of complex treatment of extensive small pelvis phlegmons in patients with diabetes mellitus

2019 ◽  
Vol 41 part 3 (2) ◽  
pp. 21-24
Author(s):  
N. N. Veligotskiy ◽  
A. S. Trushin ◽  
A. I. Seroshtanov ◽  
A. A. Sheptukha ◽  
I. Ye. Bugakov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Complex Treatment ◽  
Ozone Therapy ◽  
Treatment Results ◽  
Results Of Treatment ◽  
Patients With Diabetes

The complex treatment results of 127 patients with extensive purulent processes in diabetes mellitus that were treated in our clinic with ozone therapy and ultrasonic cavitations at 2001–2018 are presents. The problems of the course of the disease and the aggravating influence of the accompanying pathology on it are noted. The options improving the results of treatment considered.Keywords: phlegmon, small pelvis, diabetes mellitus, multiple organ failure, ozone therapy, cavitations.

scholarly journals Results Of Treatment Of Acute Diffuse Purulent Peritonitis Using Laparostomy

2020 ◽  
Vol 02 (11) ◽  
pp. 66-71
Author(s):  
S. A. Ruziboev ◽  
◽  
A. A. Avazov ◽  
Sh. Kh. Sattarov ◽  
A. N. Elmuradov ◽  
...  
Keyword(s):  
Bacterial Translocation ◽  
Abdominal Cavity ◽  
Multiple Organ ◽  
The Body ◽  
Abdominal Pressure ◽  
Results Of Treatment ◽  
Abdominal Hypertension ◽  
Purulent Peritonitis ◽  
Intractable Problems ◽  
Cause Of Deaths

Currently, despite significant achievements in the field of surgery, anesthesiology and resuscitation, the results of treatment of patients with advanced purulent peritonitis remain one of the most intractable problems, almost every sixth patient with acute surgical diseases and injuries of the abdominal cavity is admitted to medical institutions with peritonitis [1,3] Common peritonitis in 17-29% complicates the course of most acute surgical diseases and is the main cause of deaths in surgical hospitals [3,7]. Lethality in advanced peritonitis remains extremely high and reaches 20-39% [1,2,4,5]. In recent decades, great importance has been attached to recording intra-abdominal pressure in purulent pathology of the abdominal cavity. It was found that intra-abdominal hypertension occurs in every third patient with acute surgical pathology and negatively affects the functioning of all organs and systems of the body [1,6,8]. Pathological changes that occur with acute and excessive increase in intra-abdominal pressure (IAP) are manifestations of abdominal compartment syndrome (ACS) with disorders of the cardiovascular system; urinary disorders, disorders of perfusion of internal organs and the development of intestinal ischemia, which contributes to bacterial translocation and endogenous infection [2,7,8]. Ischemic blood flow disorders of the splanchnic zone are fraught with the development of bacterial translocation and the development of systemic inflammatory response syndrome and multiple organ failure (PON). Unsatisfactoriness with such results gave rise to a fundamentally different approach to the surgical treatment of common forms of peritonitis-the introduction of an open abdominal management method based on the ideas of I. Mikulich (1881), Jean-Louis Faure (1928), N. S. Makoch (1984) and D. Steinberg (1979).

Assessment of uroflowmetry indices in the diagnosis and treatment of patients with combined neurogenic pathology of the lower urinary tract and the distal part of the large intestine

2017 ◽  
pp. 48-50
Author(s):  
S.O. Vozianov ◽  
◽  
M.P. Zakharash ◽  
P.V. Chabanov ◽  
Yu.M. Zakharash ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Large Intestine ◽  
Lower Urinary Tract ◽  
Distal Part ◽  
Distal Colon ◽  
Bowel Dysfunction ◽  
Diagnostic Methods ◽  
Results Of Treatment ◽  
Urodynamic Studies ◽  
Lower Urinary

The article presents the results of treatment of patients with combined neurogenic pathology of the lower urinary tract and the distal part of the large intestine. The objective: increase the effectiveness of treatment for women with combined neurogenic pathology of the lower urinary tract and distal colon. Materials and methods. All patients with combined neurogenic pathology of the lower parts of the urinary system and lower colon were examined comprehensively using both conventional and special diagnostic methods. The study group included 30 women, whose average age was 41.8±2.1 years, the average duration of the disease was 18.4 ± 1.6 months. Efficacy was assessed using clinical and urodynamic studies. Results. The obtained results were the basis for substantiating the principles of differentiated treatment of patients with combined neurogenic pathology of the lower urinary tract and distal colon, which allowed to increase the effectiveness of treatment. Conclusions. The above data of clinical and urodynamic studies allowed to develop and optimize the methods of treatment depending on the state of the tone of the neuromuscular structures of the lower urinary tract and the distal parts of the large intestine. Key words: neurogenic disorders of urination, neurogenic bowel dysfunction, detrusor, uroflowmetry, electrostimulation.

scholarly journals Diagnosis and classification of non-epithelial stomach tumors at Viet Duc University Hospital

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Minh Đức Hoàng ◽  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Gastric Wall ◽  
Diagnostic Methods ◽  
University Hospital ◽  
Ct Scanner ◽  
Cross Sectional ◽  
Female Ratio ◽  
Stromal Tumors ◽  
Epithelial Tumors ◽  
Stomach Tumors

Abstract Introduction: To diagnose and classify for non-epithelial tumors of the stomach was difficult for physicians because of its non-specific symptoms and intensive diagnostic methods. Materials and Methods: Descriptive cross-sectional retrospective study, monitoring cases of non-epithelial tumors of the stomach surgery at Viet Duc University Hospital from 4/2014 to 5/2019. Results: In 144 cases of non-epithelial tumors of the stomach, there were 122 cases of GIST (stromal tumors had most rate 62,5%), 22 cases of gastric lymphomas, the average age was 56.9, male/female ratio was 1/1, however GIST and lymphomas being seen more in man than woman, in other side, leiomyomas and Schwann tumors being seen more in woman than a man. Diagnosis of non-epithelial gastric tumors mostly by endoscopy (87.9% tumors discovered), by ultrasound through endoscopy (100% tumors found, in that, 2 cases of lymphomas seen with the thick gastric wall), by belly ultrasound (79/113 cases, 59.4%), by CT-Scanner (100% tumors found). Diagnosis of classifying tumor by pathology: Lymphomas (100%), gastrointestinal stromal tumors (GIST) only classified by immunohistochemistry (IHC): stromal tumors (positive marker DOG1 100%, CD17 96,9%, CD34 92,9%), leiomyomas (positive marker Desmin 100%, SMA 90%), Schwann tumors (positive marker S100 100%). Conclusions: Common non-epithelial stomach tumors at Viet Duc University Hospital are stromal tumors, lymphoma, Schwann’s tumors, smooth muscle tumors also fat tumors. Diagnosis is confirmed based on disease anatomy and immunohistochemistry results with markers DOG1, CD17, CD34, Desmin, SMA, S100. Keywords: Non-epithelial tumors of the stomach, diagnose, classify, gastrointestinal stromal tumors (GIST), lymphomas, leiomyomas, Schwann tumors. Tóm tắt Đặt vấn đề: Chẩn đoán và phân loại các u dạ dày không biểu mô là một vấn đề khó đối với thầy thuốc bởi các triệu chứng thường không đặc hiệu và phương pháp chẩn đoán chuyên sâu. Phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang hồi cứu các trường hợp phẫu thuật u dạ dày không biểu mô tại Bệnh viện Hữu nghị Việt Đức từ tháng Kết quả: Có 144 người bệnh u dạ dày không biểu mô được phẫu thuật tại Bệnh viện Hữu nghị Việt Đức, trong đó có 122 người bệnh u trung mô (trong đó u mô đệm chiếm nhiều nhất 62,5%), 22 trường hợp u lympho, nhóm nghiên cứu có tuổi trung bình là 56,9, tỷ lệ nam/nữ là 1/1. Tuy nhiên u mô đệm và u lympho gặp ở nam nhiều hơn ở nữ và ngược lại, u cơ trơn và u Schwann gặp ở nữ nhiều hơn ở nam. Chẩn đoán u dạ dày không biểu mô chủ yếu bằng nội soi (87,9% phát hiện u trên nội soi), siêu âm nội soi (100% trường hợp phát hiện u, trong đó 2 trường hợp u lympho thấy dày thành dạ dày), siêu âm ổ bụng (79/133 trường hợp, 59,4%), chụp cắt lớp vi tính (100% phát hiện ra u). Chẩn đoán xác định loại u dựa vào kết quả giải phẫu bệnh: U lympho (100%), các loại u trung mô khác phải dựa vào hoá mô miễn dịch: u mô đệm (dương tính với dấu ấn DOG1 là 100%, CD17 là 96,9%, CD34 là 92,9%), u cơ trơn (dương tính với dấu ấn Desmin 100%, SMA là 90%), u Schwann (dương tính với S100 là 100%). Kết luận: U dạ dày không biểu mô thường gặp tại Bệnh viện Hữu nghị Việt Đức là u mô đệm, u lympho, u Schwann, u cơ trơn và u mỡ. Chẩn đoán xác định dựa vào giải phẫu bệnh và kết quả hoá mô miễn dịch với các dấu ấn DOG1, CD17, CD34, Desmin, SMA, S100.

Sign in / Sign up

Export Citation Format

Share Document