scholarly journals Permanent colostomy wound: Aeromedical disposal

2019 ◽  
Vol 63 ◽  
pp. 39-43
Author(s):  
U Bhattacharya ◽  
A Kumar ◽  
AVK Raju
Keyword(s):  
Rectal Cancer ◽  
Iliac Fossa ◽  
Mortality Rates ◽  
Treatment Modalities ◽  
Director General ◽  
Male Population ◽  
Aerospace Medicine ◽  
Permanent Colostomy ◽  
Post Surgery ◽  
History Of

Background: A 41-year-old test pilot from the fighter stream presented to the Institute of Aerospace Medicine (IAM) with carcinoma lower one-third of rectum (opted) and a history of 2 years of follow-up post-surgery. He was physically fit with a healthy stoma in the left iliac fossa region. There was no history of local recurrence or distance metastases of colorectal cancer (CRC). During his evaluation at IAM, the officer had completed the OPTRAM profile with a stomal guard in place and could do AGSM effectively. Considering the overall prognosis, which was found to be favorable, the pilot was recommended an upgradation to a restricted flying category in the type, subject to a 1 time waiver from Director General Medical Services (air). Discussion: According to the Indian Council of Medical Research consensus document for the management of CRC 2014, the annual incidence rate of colon cancer and rectal cancer in Indian male population is 4.4 and 4.1/100,000, respectively. Surgery is the primary treatment for such cancers and they are mostly curative. Multimodal therapy with neoadjuvant chemotherapy and radiotherapy is done to improve the survival rates. Latest reports published by the National Comprehensive Cancer Network for Rectal Cancer, Version 2.2018, Clinical Practice Guidelines in Oncology indicate that the peak mortality rates are currently down by 50% due to better treatment modalities. Depending on the site of primary tumor, the surgery might leave the patient with either a temporary or a permanent colostomy wound. Conclusion: There was no available record/published case report of any pilot being returned to the cockpit in military flying with a permanent stoma. This case was a first of its kind with respect to aeromedical decisionmaking. With mortality rates decreasing due to effective treatment for cancer, aeromedical decision in more such cases may be required in the future. This case will serve as a precedence in effectively returning trained aviators to the cockpit.

Unusual Case of Pyogenic Spondylodiscitis, Vertebral Osteomyelitis and Bilateral Psoas Abscesses after Acupuncture: Diagnosis and Treatment with Interventional Management

2015 ◽  
Vol 33 (2) ◽  
pp. 154-157 ◽  
Author(s):  
Chengjian He ◽  
Tao Wang ◽  
Yifeng Gu ◽  
Qinghua Tian ◽  
Bi Zhou ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Vertebral Osteomyelitis ◽  
Complete Relief ◽  
External Drainage ◽  
Permanent Colostomy ◽  
Pyogenic Spondylodiscitis ◽  
Relieve Pain ◽  
History Of ◽  
First Time ◽  
Abnormal Uptake

Background We report, for the first time, a case of pyogenic spondylodiscitis combined with vertebral osteomyelitis and bilateral psoas abscesses after acupuncture. Case History A 60-year-old man was diagnosed with rectal cancer, and radical rectectomy and permanent colostomy were carried out. However, 3 years after the surgery the patient complained of pain in the lower back, and the symptoms worsened after seven sessions of acupuncture. Technetium 99m-labelled methylene diphosphonate (99mTc-MDP) bone scintigraphy (BS) revealed abnormal uptake of 99mTc-MDP in the L4 and L5 vertebrae. He was admitted to our hospital because of suspected bone metastases from rectal cancer. He was diagnosed with infection based on a history of acupuncture and the findings of enhanced MRI and CT. Percutaneous lumbar discectomy (PLD), external drainage and irrigation using antibiotics were carried out to treat the L4−5 disc. Pathological analyses and bacterial culture of the resected disc confirmed infection with group C streptococcus. Postoperative antibiotic treatment resulted in significant pain relief on the third day and gradual complete relief. Considerable improvement was seen on CT and MRI at follow-up. Conclusions We consider it highly likely that this patient's infection was caused by acupuncture. In patients with malignancy, abnormal uptake of 99mTc-MDP in BS may signify bone metastasis but can also be observed in bone infections. PLD can be used to resect diseased discs to relieve pain quickly and to prevent herniation of lumbar discs. After PLD, external drainage can be employed for abscess drainage, decompression and perfusion of antibiotics. PLD may serve as an alternative to open surgery for pyogenic spondylodiscitis.

scholarly journals Perforation of a Meckel’s diverticulum secondary to chronic NSAID use: case report and review of the literature

2020 ◽  
Vol 7 (9) ◽  
pp. 3082
Author(s):  
Francisco Terrazas Espitia ◽  
David Molina Davila ◽  
Luis Villalobos Ramirez ◽  
Bruno Salazar Trujillo ◽  
Lucio Santos Moyron ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
Acute Onset ◽  
Meckel's Diverticulum ◽  
Male Population ◽  
History Of ◽  
Heterotopic Tissue ◽  
The Right

Meckel´s diverticulum is an abnormality in the development of the gastrointestinal system, its origin and clinical significance was first described by Johan Friedrich Meckel in 1809. It is a remnant of the omphalomesenteric duct which is usually observed following the rule of 2’s, located 2 feet proximal to the ileocecal valve, before 2 years of age in approximately 2% of the population, and is twice as common in male population. It is considered a true diverticulum because it presents all the histopathological layers of the bowel; 6% of the cases present with heterotopic tissue, mainly pancreatic, gastric, colonic or jejunal. We present the case of a 37-year-old patient who presented with acute onset epigastric pain which migrated to the right iliac fossa, he had a history of chronic non-steroidal anti-inflammatory drugs (NSAIDs) usage for articular pain. He underwent abdominal contrast tomography (CT) scan with double iodine contrast enhancement, which revealed the presence of a perforated Meckel´s diverticulum in the antimesenteric portion of the terminal ileum. The patient underwent laparoscopic diverticulectomy with no complications and was discharged 72 hours after the procedure. Histopathological confirmation of a perforated meckel’s diverticulum with heterotopic gastric mucosa confirmed the clinical suspicion of perforation secondary to chronic NSAIDs usage.

Features of mortality of the male population of the monotown, which is the industrial center of non-ferrous metallurgy

2020 ◽  
pp. 772-772
Author(s):  
G. I. Tikhonova ◽  
M. S. Bryleva ◽  
T. Yu. Gorchakova
Keyword(s):  
Ferrous Metallurgy ◽  
Digestive System ◽  
Circulatory System ◽  
Mortality Rates ◽  
Malignant Neoplasms ◽  
Male Population ◽  
Murmansk Region ◽  
Metallurgical Company ◽  
Industrial Center

Standardized mortality rates of the male population aged 15-59 in Monchegorsk, where the Kola mining and metallurgical company is located, were higher relative to the Murmansk region and Russia: from diseases of the circulatory system by 34.8% and 52.1%, respectively, from malignant neoplasms by 26.3% and 19.4%, from diseases of the digestive system by 59.0% and 36.3%.

Lockdown dilemma: ingestion of magnetic beads presenting as right iliac fossa pain and subacute small bowel obstruction

2020 ◽  
Vol 13 (11) ◽  
pp. e236429
Author(s):  
Bankole Oyewole ◽  
Anu Sandhya ◽  
Ian Maheswaran ◽  
Timothy Campbell-Smith
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Magnetic Beads ◽  
Iliac Fossa ◽  
Serous Fluid ◽  
Magnetic Resonance Scan ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
Multiple Episodes ◽  
Safety Netting

A 13-year-old girl presented with a 3-day history of migratory right iliac fossa pain. Observations and inflammatory markers were normal, and an ultrasound scan was inconclusive. A provisional diagnosis of non-specific abdominal pain or early appendicitis was made, and she was discharged with safety netting advice. She presented again 6 days later with ongoing abdominal pain now associated with multiple episodes of vomiting; hence, the decision was made to proceed to diagnostic laparoscopy rather than a magnetic resonance scan for further assessment. Intraoperative findings revealed 200 mL of serous fluid in the pelvis, normal-looking appendix, dilated stomach and a tangle of small bowel loops. Blunt and careful dissection revealed fistulous tracts that magnetised the laparoscopic instruments. A minilaparotomy was performed with the extraction of 14 magnetic beads and the repair of nine enterotomies. This case highlights the importance of careful history taking in children presenting with acute abdominal pain of doubtful aetiology.

scholarly journals Transperineal total mesorectal excision for rectal cancer on the residual rectum after multiple abdominal surgeries in a patient with Crohn’s disease: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shin Emoto ◽  
Shigenori Homma ◽  
Tadashi Yoshida ◽  
Nobuki Ichikawa ◽  
Yoichi Miyaoka ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intraoperative Complications ◽  
Rectal Stump ◽  
Stage I ◽  
Colonoscopic Examination ◽  
Case Presentation ◽  
History Of ◽  
Blood Loss Volume

Abstract Background The improved prognosis of Crohn’s disease may increase the opportunities of surgical treatment for patients with Crohn’s disease and the risk of development of colorectal cancer. We herein describe a patient with Crohn’s disease and a history of multiple surgeries who developed rectal stump carcinoma that was treated laparoscopically and transperineally. Case presentation A 51-year-old man had been diagnosed with Crohn’s disease 35 years earlier and had undergone several operations for treatment of Crohn’s colitis. Colonoscopic examination was performed and revealed rectal cancer at the residual rectum. The patient was then referred to our department. The tumor was diagnosed as clinical T2N0M0, Stage I. We treated the tumor by combination of laparoscopic surgery and concomitant transperineal resection of the rectum. While the intra-abdominal adhesion was dissected laparoscopically, rectal dissection in the correct plane progressed by the transperineal approach. The rectal cancer was resected without involvement of the resection margin. The duration of the operation was 3 h 48 min, the blood loss volume was 50 mL, and no intraoperative complications occurred. The pathological diagnosis of the tumor was type 5 well- and moderately differentiated adenocarcinoma, pT2N0, Stage I. No recurrence was evident 3 months after the operation, and no adjuvant chemotherapy was performed. Conclusion The transperineal approach might be useful in patients with Crohn’s disease who develop rectal cancer after multiple abdominal surgeries.

GUT-DIRECTED SELF-HYPNOSIS FOR INFLAMMATORY BOWEL DISEASE PROTOCOL: COMPLIMENTARY PSYCHOTHERAPY FOR REMISSION AUGMENTATION, IBS-LIKE SYMPTOMS, AND SURGERY RECOVERY

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S53-S53
Author(s):  
Joshua Paulton ◽  
Amanjot Gill ◽  
Joelle Prevost
Keyword(s):  
Inflammatory Bowel Disease ◽  
Stress Response ◽  
Mechanism Of Action ◽  
Bowel Disease ◽  
Relaxation Techniques ◽  
Markers Of Inflammation ◽  
Post Surgery ◽  
Patient Goals ◽  
History Of ◽  
Inflammatory Bowel

Abstract Background Gut-directed hypnosis (GDH) is a complimentary therapy for Inflammatory Bowel Disease (IBD), that can be learnt by patients to practice self-hypnosis. GDH in IBD has augmented remission and improved inflammation. GDH has a history of successful use for Irritable Bowel Syndrome (IBS). In IBD it may also improve IBS-like symptoms in remission and recovery from surgery. GDH is suitable for youth and adult IBD patients. In hypnosis, a relaxed state is inducted then suggestions to subconscious mind processes are made. In IBD, the mechanism of action of GDH is unknown but may influence the disease stress response. Aims Aims are the development of a GDH self-hypnosis protocol for IBD, with appropriate target symptoms. Patients first learn to practice with a clinician, then as complimentary psychotherapy for remission augmentation, IBS-like symptoms, and surgery recovery. Methods GDH is practiced first with a clinician, and then by patients as self-hypnosis (table 1). Patients receive psycho-education on GDH for IBD. Next, appropriate treatment goals are made, based on target symptoms. Relaxation techniques induce patient to a deeply relaxed state. Therapeutic suggestions specific to patient goals are given: verbal suggestions, visualizations, and post-hypnotic suggestions. Suggestions can focus on having a healthy digestive system, inflammation and symptoms reduction, and achievement and sustainment of remission. Patients emerge from hypnosis, are debriefed, and encouraged to practice ongoing self-hypnosis. Results In IBD, GDH self-hypnosis can be learnt from clinicians and practiced by patients as a complimentary therapy. Patients’ achievement and sustainment of remission, with clinical markers of inflammation can be monitored. Patients can monitor subjective improvement of IBS-like symptoms and post surgery, recovery progress can be monitored. Conclusions GDH has a history of use for IBS. In IBD, it has been shown to modulate remission, and may improve IBS-like symptoms, and in surgery recovery. The mechanism of action of GDH in IBD may influence the disease stress response. Clinicians trained in GDH are limited currently. Patients may learn GDH self- hypnosis to as a complimentary psychotherapy.

scholarly journals How to Intervene in the Health Management of the Oncological Patient and of Their Caregiver? A Narrative Review in the Psycho-Oncology Field

2021 ◽  
Vol 11 (7) ◽  
pp. 99
Author(s):  
Gian Piero Turchi ◽  
Marta Silvia Dalla Riva ◽  
Luisa Orrù ◽  
Eleonora Pinto
Keyword(s):  
Quality Of Life ◽  
Health Management ◽  
Psychological Treatment ◽  
Management Strategies ◽  
Well Being ◽  
Narrative Review ◽  
Treatment Modalities ◽  
Oncological Patient ◽  
Post Surgery

Starting from statistical data derived from the oncological field, some articles have highlighted the importance of communication in the patient–caregiver dyad and have considered the various roles involved in a cancer diagnosis situation. Thus, the question of how to intervene in terms of “quality of life” from the time of diagnosis to the recovery or death of a cancer patient, beyond the sanitary and physical dimensions, has become relevant. Therefore, the present narrative review aims to offer an overview of the state of the art in terms of the psychological treatment modalities of cancer patients, from the diagnosis to the post-surgery period. A total of 67 articles were collected and analyzed, in relation to (1) psychological constructs employed in the oncological field, (2) intervention models and (3) quality of life and well-being measurement and evaluation tools. We described these articles, differentiating between those focusing on the role of (1) the patient, (2) the caregiver, (3) the patient–caregiver dyad and (4) healthcare professional roles. The oncological diagnosis and its repercussions in the lives of the patient and caregiver were explored and critical aspects that emerged from the literature were highlighted. In conclusion, the analysis allowed some considerations about the need to define research protocols and useful management strategies for increasing the overall health of patients with cancer diagnoses and the people who surround them.

scholarly journals The fat anchor orchiopexy technique: results and outcomes from 150 cases surgical experience

2021 ◽  
Author(s):  
Claudio Spinelli ◽  
Alessia Bertocchini ◽  
Gianmartin Cito ◽  
Marco Ghionzoli ◽  
Silvia Strambi
Keyword(s):  
Undescended Testis ◽  
Healing Process ◽  
Day Surgery ◽  
Post Surgery ◽  
Post Operative Pain ◽  
Surgical Wounds ◽  
Bilateral Cryptorchidism ◽  
Long Time ◽  
History Of

Abstract Purpose The purpose of the study is to evaluate results and outcomes in a long-time follow-up period, by performing a novel testicular fixation procedure, known as “fat anchor orchidopexy” (FAO), for the treatment of palpable low inguinal undescended testis. Materials and methods We retrospectively reviewed all patients who underwent scrotal orchiopexy technique, from May 2013 to May 2019, at the Pediatric Surgery Division of Department of Surgical Pathology, University of Pisa (Italy). FAO (Spinelli’s technique) consists in anchoring the testicles to sub-scrotal fat with a single trans-scrotal incision. All the patients enrolled had history of unilateral or bilateral undescended testis. Data collected included patient’s age, operative times and complications. Results A total of 150 children with cryptorchidism were treated using a single trans-scrotal orchiopexy. Of them, 130 patients (86.7%) had unilateral undescended testis and 20 (13.3%) bilateral cryptorchidism. Mean patient’s age was 21 months (range: 14–28 months). All the procedures were planned in a day-surgery setting. Trans-scrotal orchiopexy was successful in all cases and no patients required an additional groin incision. No intraoperatively and postoperatively major complications were observed. Patients’ post-operative pain was mild (mean pediatric visual analog scale = 2). In all cases, the healing process was rapid and no surgical wounds infections were reported during the post-operative period, referring excellent cosmesis results. During a mean 48-month follow-up period, no testicular retraction, recurrence or testis atrophy was reported. Conclusion The original Spinelli’s technique (FAO) proves to be a safe and effective method for the treatment of palpable or distal-to-external-inguinal-ring testes. No immediate and delayed post-surgery complications were reported. In all cases, the anchored testicle remained in the scrotal position with normal vascularization. This novel surgical technique could give better options for scrotal fixation in case of low-lying cryptorchid testes.

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