scholarly journals Intestinal anastomosis blowout following post-operative cardiopulmonary resuscitation: A case report

2021 ◽  
pp. 190
Author(s):  
◽  
◽  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Rare Complication ◽  
Bowel Perforation ◽  
Intestinal Anastomosis ◽  
Clinical Status ◽  
Colorectal Anastomosis ◽  
Pulseless Electrical Activity ◽  
Operative Management ◽  
Sigmoid Resection ◽  
Water Soluble

Background: Pneumoperitoneum following cardiopulmonary resuscitation (CPR) is a very rare complication with a challenging management. In this paper we describe the management of a patient who suffered a blowout of his colorectal anastomosis after undergoing CPR for a cardiac arrest in the early post-operative period. Additionally, we present a thorough literature review of the management of CPR-related pneumoperitoneum. Summary: Five days after a sigmoid resection for colon cancer, a 71-year-old male went into pulseless electrical activity and CPR was initiated, with complete clinical recovery. After CPR the patient was found to have new hydropneumothorax and pneumoperitoneum. Because he had a normal abdominal examination, lack of leukocytosis, and no evidence of a bowel perforation on water-soluble CT imaging, the patient was initially managed non-operatively with close clinical follow-up. However, he failed the non-operative management and ultimately required a laparotomy demonstrating a blowout of his colonic anastomosis. Conclusion: Physicians should remain aware of the risk of damage to fresh bowel anastomoses following CPR. There should be a low threshold for surgical exploration in patients that develop CPR-related pneumoperitoneum soon after intestinal surgery, even when patient’s clinical status is stable.

scholarly journals Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi

2021 ◽  
Vol 18 (3) ◽  
pp. 176-179
Author(s):  
Ephraim Bitilinyu-Bangoh ◽  
Fatsani Mwale ◽  
Loveness Ulunji Chawinga ◽  
Gift Mulima
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Anastomosis ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
Sigmoid Resection ◽  
Sigmoid Volvulus ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Kamuzu Central Hospital

Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to  describe the surgical  management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data  extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid  resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in  mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has  significant oedema or is gangrenous.

scholarly journals Experience with multidisciplinary laparoscopic surgery in patients with deep infiltrating colorectal endometriosis

2014 ◽  
Vol 155 (5) ◽  
pp. 182-186 ◽  
Author(s):  
Attila Bokor ◽  
Réka Brubel ◽  
Péter Lukovich ◽  
János Rigó jr.
Keyword(s):  
Bowel Resection ◽  
Rectal Resection ◽  
Colorectal Anastomosis ◽  
Sigmoid Resection ◽  
Deep Infiltrating Endometriosis ◽  
Colorectal Endometriosis ◽  
Segmental Bowel Resection ◽  
The Mean ◽  
Colorectal Resections ◽  
Infiltrating Endometriosis

Introduction: Deep infiltrating endometriosis is a particular form of endometriosis that penetrates the peritoneal surface or it reaches the subserosal neurovascular plexus. Aim: The aim of the authors was to analyze the results of segmental colorectal resections performed for deep infiltrating endometriosis. Method: Between 2009 and 2012, 50 patients underwent segmental rectum or/and sigmoid resection for endometriosis. Results: 21 patients had ultralow rectal resection and 29 patients had low colorectal anastomosis or anterior resection. Concomitant intervention in other organs was required in all cases, including gynecologic procedures (n = 50), additional gynecologic (n = 47), vesical (n = 9) and ureteral (n = 18) resections. The mean number of endometriosis lesions was 2.4±1.8 per patient. In all patients fertility was preserved. Severe surgical complications (Clavien–Dindo stage III or more severe) occurred in 3 patients (6%). Conclusions: The results confirm that segmental bowel resection is an efficient and safe method for the treatment of deep infiltrating colorectal endometriosis. Orv. Hetil., 2014, 155(5), 182–186.

scholarly journals Small bowel perforation secondary to CMV-positive terminal ileitis postrenal transplant

2019 ◽  
Vol 12 (11) ◽  
pp. e231662 ◽  
Author(s):  
Kosuke Kato ◽  
Michelle Cooper
Keyword(s):  
Small Bowel ◽  
Rare Complication ◽  
Bowel Perforation ◽  
Lower Abdominal Pain ◽  
Right Hemicolectomy ◽  
Small Bowel Perforation ◽  
Cmv Infection ◽  
Terminal Ileitis ◽  
Intravenous Ganciclovir ◽  
Cmv Disease

Cytomegalovirus (CMV) infection of the gastrointestinal tract is common in immunosuppressed patients; however, small bowel perforation from tissue-invasive CMV disease after many years of immunosuppressive therapy is a rare complication requiring timely medical and surgical intervention. We report a case of a postrenal transplant patient who presented to the emergency department with severe lower abdominal pain with CT of the abdomen/pelvis revealing a small bowel perforation. He underwent an emergent laparoscopic right hemicolectomy, and his histopathology of the terminal ileum was positive for CMV disease. He was successfully treated with intravenous ganciclovir postoperatively. We discuss the pathophysiology, histopathological features and treatment of CMV infection.

scholarly journals Rare Case of Large Bowel Injury due to Direct Blunt Trauma to a Preexisting Femoral Hernia

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
C. Tinner ◽  
M. Odermatt ◽  
P. Villiger
Keyword(s):  
Blunt Trauma ◽  
Femoral Hernia ◽  
Bowel Perforation ◽  
Colorectal Anastomosis ◽  
Oral Feeding ◽  
Inguinal Region ◽  
Emergency Laparotomy ◽  
Time Interval ◽  
Hernia Sac ◽  
Left Inguinal Region

We report a case of an 85-year-old man with a known asymptomatic left femoral hernia who was admitted to the emergency ward a few hours after falling from a bicycle and suffering from blunt trauma of the handlebar to the left inguinal region. The clinical findings and a computed tomography (CT) scan detecting free air in the femoral hernia sac suggested bowel perforation. Emergency laparotomy 6 hours after the incident confirmed a tear of the sigmoid colon accompanied by free blood and faeces in the left inguinal region of the abdomen. A segmental sigmoid resection and a primary end-to-end colorectal anastomosis were performed. The postoperative course was complicated by delayed oral feeding, a local infection, and a partial left testicle necrosis that led to secondary resection. The patient was discharged after 32 days of in-hospital care. Three months post trauma, we recorded a restitutio ad integrum. The case exemplifies that blunt trauma to preexisting femoral hernias may cause potentially lethal bowel perforation and that the time interval between time of injury and surgical treatment may be a prognostic factor. CT scans seem most suitable for ruling out bowel perforation. The scarce literature for blunt trauma to hernias is reviewed.

scholarly journals Case report of enterocutaneous fistula due to non-functioning ventriculoperitoneal shunt

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Jha Prabhat ◽  
Joshi Bijendra Dhoj
Keyword(s):  
Case Report ◽  
Bowel Resection ◽  
Rare Complication ◽  
Enterocutaneous Fistula ◽  
Bowel Perforation ◽  
Young Male ◽  
Shunt Patient ◽  
Vp Shunt ◽  
Abdominal Complications ◽  
Resection And Anastomosis

Abstract Abdominal complications after placement of ventriculoperitoneal (VP) shunt are commonly reported but asymptomatic bowel perforation with enterocutaneous fistula (ECF) is rare. This case describes a young male patient who underwent VP shunt for hydrocephalus 10 years ago. He presented with ECF due to the non-functioning abdominal end of the shunt. Patient was managed with laparotomy with fistulectomy with bowel resection and anastomosis. ECF is a rare complication of VP shunt.

The Effects of Hyperthermic Intraperitoneal Chemoperfusion on Colonic Anastomosis: An Experimental Study in a Rat Model

2017 ◽  
Vol 103 (3) ◽  
pp. 307-313 ◽  
Author(s):  
Afag Aghayeva ◽  
Cigdem Benlice ◽  
Ismail Ahmet Bilgin ◽  
Pinar Atukeren ◽  
Gulen Dogusoy ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Rat Model ◽  
Colonic Anastomosis ◽  
Colorectal Anastomosis ◽  
Sigmoid Resection ◽  
Albino Rats ◽  
Bursting Pressure ◽  
Negative Effects ◽  
Significant Difference ◽  
Group 2

Introduction Cytoreductive surgery (CRS) with subsequent hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising modality to treat and prevent peritoneal metastases. However, this treatment is associated with signficant morbidity and mortality. Whether or not CRS with HIPEC interferes with anastomotic healing has also been debated. This study was designed to investigate the effects of mitomycin C, cisplatin, oxaliplatin, and doxorubicin used in HIPEC treatment on colonic anastomosis healing in a rat model. Methods Sixty Wistar albino rats were employed in the study. Sigmoid resection and end-to-end colorectal anastomosis was performed in all rats. Group 1 rats underwent the surgical procedure alone, while group 2 rats were given hyperthermic intraperitoneal lavage with heated saline following surgery. Groups 3, 4, 5, and 6 had surgery with concomitant HIPEC treatment with mitomycin C, cisplatin, oxaliplatin, and doxorubicin, respectively. Anastomotic bursting pressures and hydroxyproline levels were evaluated. Results Regarding the hydroxyproline levels, groups 1 and 2 showed significantly higher values than other groups (p<0.001). However, there was no significant difference between the HIPEC treatment groups (groups 3, 4, 5, and 6) (p>0.05). When groups were compared regarding bursting pressure values, no significant differences were observed (p = 0.81). Conclusions This study demonstrated that the HIPEC procedure with mitomycin C, cisplatin, oxaliplatin and doxorubicin had negative effects on hydroxyproline levels, but had no detrimental effect on anastomotic bursting pressure in a rat model.

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