Colonic Diseases ; diagnosis ; etiology ; surgery ; Female ; Humans ; Infant, Newborn ; Intestinal Perforation ; diagnosis ; etiology ; surgery ; Male

Colon, Ascending ; injuries ; Foreign Bodies ; complications ; Humans ; Intestinal Perforation ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Seafood

Duodenal diverticula are common, but perforated duodenal diverticulum is rare. Because of the disease rarity, there is no standard management protocol for perforated duodenal diverticulum. To properly manage this rare complication, a clear preoperative diagnosis and clinical disease severity assessment are important. An abdomino-pelvic CT is an unquestionably crucial diagnostic tool. Perforation is considered a surgical emergency, although conservative treatment based on fasting and broad-spectrum antibiotics may be offered in some selected cases. Herein, we report two cases of perforated duodenal diverticulum, one case managed with surgical treatment and one with conservative treatment.
Aged ; Diverticulum/complications/*diagnosis/surgery ; Duodenal Diseases/complications/*diagnosis/surgery ; Endoscopy, Digestive System ; Humans ; Intestinal Perforation/*diagnosis/etiology/surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

Peutz-Jeghers syndrome is an autosomal dominant inherited disorder characterized by multiple gastrointestinal hamartomatous polyps and mucocutaneous pigmentation. Peutz-Jeghers syndrome has an incidence of approximately 1 in 25,000 to 300,000 births. Crohn's disease is a chronic inflammatory bowel disease that typically manifests as regional enteritis with its incidence ranging from 3.1 to 14.6 cases per 100,000 person-years in North America. Herein, we report a case of a 30-year-old male patient who had both Peutz-Jeghers syndrome and Crohn's disease. We believe that this is the first case in Korea and the second report in the English literatures on Peutz-Jeghers syndrome coincidentally accompanied by Crohn's disease.
Adult ; Crohn Disease/complications/*diagnosis/pathology ; Endoscopy, Gastrointestinal ; Humans ; Intestinal Obstruction/etiology ; Intestinal Perforation/etiology ; Intestinal Polyps/pathology/surgery ; Male ; Peutz-Jeghers Syndrome/complications/*diagnosis/genetics ; Protein-Serine-Threonine Kinases/genetics

OBJECTIVETo improve the diagnosis and treatment of abdominal injury.

METHODSThe clinical data of 286 patients with gastrointestinal tract laceration admitted between 2004 and 2009 to our hospital was analyzed.

RESULTSThe duration after trauma was 15 min to 2 days. Of the 286 patients eventually confirmed by laparotomy, 273 were cured, 3 showed improvement and 10 died.

CONCLUSIONAbdominal trauma in patients with gastrointestinal tract laceration, Abdominal puncture diagnosis and orthostatic abdominal X-ray are rapid and effective diagnostic methods for gastrointestinal tract laceration in patients with abdominal trauma. Laparotomy is the primary treatment measures and should be performed as early as possible.

Abdominal Injuries ; complications ; diagnosis ; surgery ; Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Intestinal Perforation ; etiology ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

No abstract available.
Endoscopy, Digestive System ; Female ; Humans ; Intestinal Perforation/*diagnosis/etiology/surgery ; Jejunal Diseases/*diagnosis/etiology/surgery ; Jejunal Neoplasms/complications/*diagnosis/pathology ; Lymphoma, B-Cell, Marginal Zone/complications/*diagnosis/pathology ; Middle Aged ; Tumor Markers, Biological/analysis

Endoscopic variceal ligation (EVL) can be performed as an optional therapy for gastric variceal bleeding if endoscopic sclerotherapy (ES) is not readily available or if practitioners lack experience. EVL using an endoscopic pneumo-activated ligating device was performed on a 53-year-old male patient with liver cirrhosis who presented with hematemesis. Follow-up esophagogastroduodenoscopy (EGD) performed two days after the EVL showed gastric perforation at the EVL-procedure site on the gastric fundus. However, the patient refused emergency surgery, and therefore received only supportive management, including intravenous antibiotics. EGD 10 days later showed healing of the perforation site. This is the first report of a case of gastric variceal bleeding with development of a gastric perforation soon after EVL, which showed complete recovery with conservative therapy and without surgical intervention.
Endoscopy, Digestive System ; Esophageal and Gastric Varices/*surgery ; Gastrointestinal Hemorrhage ; Humans ; Intestinal Perforation/etiology ; Ligation/adverse effects ; Liver Cirrhosis/diagnosis ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the risk factors affecting the early postoperative outcomes in patients with small bowel obstruction.

METHODSClinical data of 193 patients with small bowel obstruction undergone operation were analyzed retrospectively. A range of factors were investigated to estimate postoperative outcome, including gender, age, comorbidities, etiology of obstruction, presence of strangulated bowel (viable or nonviable), leukocyte count, temperature, and heart rate. Logistic regression analysis was used to study the prognostic value of each significant variable in terms of postoperation.

RESULTSThe major causes of small bowel obstruction were adhesion and hernia, contributing 38.9% and 37.8% of all cases, respectively. Strangulation occurred in 42.0% and caused nonviable bowel in 23.3% of obstructing episodes. Elderly (>or=70 years), diabetes, malignant tumors WBC >15x10(9)/L were independent significant factors associated with bowel strangulation. The overall complication rate was 16.1%, the 30-day mortality was 4.1%, and the median postoperative hospital stay was 13 days. Age >or=70 years and bowel resection were significantly associated with postoperative complications in the univariate analysis. Only elderly and malignant obstruction were significantly associated with operative mortality in multivariate logistic regression.

CONCLUSIONSSurgery for small bowel obstruction is still associated with significant mortality and morbidity. Elderly is significantly associated with an increased incidence of strangulation, operative mortality, and complications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Incidence ; Intestinal Obstruction ; diagnosis ; etiology ; surgery ; Intestinal Perforation ; epidemiology ; Intestine, Small ; surgery ; Logistic Models ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Young Adult

BACKGROUND/AIMS: A stercoral perforation of the colon (SPC) is a rare, life-threatening disease. The aim of this study was to represent the definition of SPC and help the diagnosis and treatment of this condition. METHODS: We reviewed 92 medical records of patients who underwent operation due to colonic perforation from January 2000 to February 2009 retrospectively. Maurer's diagnostic criteria were used for the diagnosis of SPC. RESULTS: Eight patients (8.7%) were diagnosed as SPC. The age of the patients ranged from 59 to 85 years old. All of the patients were female and had a history of long-standing constipation. Only two patients (25%) were diagnosed as SPC preoperatively. The site of perforation of all patients was sigmoid colon. The methods of operation were Hartmann's procedure (7 cases), and primary repair with sigmoid loop colostomy (1 case). There were one recurrence and two deaths (25%) due to sepsis and multiple organ failure. CONCLUSIONS: SPC should be considered in chronically constipated, and bedridden patients who present with acute abdomen. Hartmann's procedure is the treatment of choice in most situations. Mortality is high but can be minimized with early definitive surgery.
Aged ; Aged, 80 and over ; Colon, Sigmoid/pathology ; Colonic Diseases/*diagnosis/radiography/surgery ; Female ; Humans ; Intestinal Perforation/*diagnosis/radiography/surgery ; Middle Aged ; Postoperative Complications ; Respiratory Distress Syndrome, Adult/etiology ; Retrospective Studies ; Sepsis/etiology ; Tomography, X-Ray Computed

Endoscopic retrograde biliary drainage (ERBD) is useful for the palliative decompression of biliary obstruction. However, the complications of ERBD include cholangitis, hemorrhage, acute pancreatitis, obstruction of the stent, and duodenal perforation. Pressure necrosis on the duodenal mucosa by the stent may contribute to perforation. Although duodenal perforation following ERBD is very rare compared to other complications, it can result in a fatal outcome. Recent reports describe nonsurgical treatment for small gastrointestinal perforation with localized peritonitis and suggest that endoclipping may be appropriate in the management of a well selected group of patients with iatrogenic perforation. We describe a case of duodenal perforation secondary to ERBD that was successfully treated with approximating using endoclip and detachable snare.
Bile Ducts, Extrahepatic ; Biliary Tract Diseases/complications/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Duodenal Diseases/*diagnosis/etiology/therapy ; Female ; Gallbladder Neoplasms/diagnosis ; Humans ; Intestinal Perforation/*diagnosis/etiology/therapy ; Middle Aged ; Plastics ; Stents/*adverse effects ; Tomography, X-Ray Computed