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Rev Gastroenterol Peru 2018 Jul-Sep;38(3):261-264

Universidad Cooperativa de Colombia. Pasto, Nariño, Colombia.

Peritonitis is one of the main complications of abdominal emergencies. Laparoscopy serves both for the diagnostic and therapeutic management of the acute abdomen; in expert hands the morbimortality of this method is minimal.

Objective: The objective is to verify the efficacy of laparoscopy in patients with secondary peritonitis performing a single surgery without the need for reinterventions, ensuring the least damage of the abdominal wall, avoiding laparotomy. Read More

Indian J Surg Oncol 2018 Dec 20;9(4):511-518. Epub 2018 Jul 20.

1Department of Gynaecologic Oncology, CMC Hospital, Vellore, 632004 India.

To evaluate the mortality and morbidity related to bowel resection in women with advanced ovarian carcinoma. Retrospective case series of 47 women with stage III and IV carcinoma ovary who underwent bowel resection, over the period of 5 years from Jan 2011 to Dec 2015. The risk factors for perioperative morbidity and death were determined by regression analysis. Read More

Indian J Surg Oncol 2018 Dec 4;9(4):442-451. Epub 2018 Aug 4.

3Pathology Department, Faculty of Medicine, Benha University, Benha, Egypt.

We are trying to illustrate operative, short-term, and pathological outcomes of transanal total mesorectal excision (TaTME) as a surgical procedure for patients who are suffering cancer in the lower or middle rectum. This study included 25 consecutive patients who underwent TaTME for the mid and low cancer rectum. The primary outcome measures included frequency of postoperative (PO) bleeding, leakage, ileus, days to regain bowel function, days for Foley's removal, and erectile function. Read More

Int J Colorectal Dis 2018 Dec 10. Epub 2018 Dec 10.

Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.

Aim: The association between preoperative use of monoclonal antibodies in inflammatory bowel disease (IBD) patients and postoperative complications is controversial, especially for the latest approved biologics, ustekinumab and vedolizumab, where data is limited. We hypothesized that ustekinumab-treated patients would have a similar overall postoperative complication rate as vedolizumab-treated patients. The aim of this study was to compare postoperative complications in patients receiving preoperative ustekinumab vs. Read More

Clinicoecon Outcomes Res 2018 14;10:761-771. Epub 2018 Nov 14.

Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA,

Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.

Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009-2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Read More

Khirurgiia (Mosk) 2018 (11):71-79

S.M. Kirov Military Medical Academy Ministry of Defense of the Russia.

Effectiveness of enhanced recovery program is being earnestly confirmed in various surgical areas. Certain aspects of fast track rehabilitation are analyzed in the article. Read More

Khirurgiia (Mosk) 2018 (10):55-60

Sechenov First Moscow State Medical University of Healthcare Ministry of Russia, Moscow, Russia; Petrovsky Russian Research Center for Surgery, Moscow, Russia.

Aim: To determine optimal treatment strategy for acute malignant colonic obstruction.

Material And Methods: 349 patients with acute malignant colonic obstruction were retrospectively analyzed for the period 2005-2017. All patients were divided into two groups depending on surgical approach. Read More

Khirurgiia (Mosk) 2018 (10):39-43

Pirogov Russian National Research Medical University of Healthcare Ministry of Russia, Moscow, Russia.

Aim: To analyze informative value of radiological diagnosis of acute gallstone ileus.

Material And Methods: There were 7 patients with acute gallstone ileus who underwent diagnostic abdominal X-ray examination, ultrasonography and computed tomography.

Results: There was high informative value of CT for acute gallstone ileus if it was applied within the first hours after admission. Read More

Int J Colorectal Dis 2018 Dec 5. Epub 2018 Dec 5.

Department of Surgery, University Hospital of Bonn, Bonn, Germany.

Purpose: Postoperative ileus (POI) is a common complication after abdominal surgery. Invasive stimulation of the cervical vagus nerve is known to reduce inflammatory response and ameliorated POI after surgery in a mouse model. However, the transcutaneous vagus nerve stimulation (tVNS) is a possible non-invasive approach. Read More

Open Med (Wars) 2018 25;13:562-564. Epub 2018 Nov 25.

Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.

Chronic intestinal pseudo-obstruction (CIPO) is a functional gastrointestinal disorder with symptoms of ileus. CIPO can either be idiopathic or secondary to other diseases such as systemic lupus erythematosus (SLE). SLE is involved in many parts of the gastrointestinal system with variable clinical presentations. Read More

Ugeskr Laeger 2018 Nov;180(48)

Appendicitis is a common condition, which is often seen by the general practitioners as well as in the emergency departments. It is normally treated with laparoscopic appendectomy. This review gives an overview of the long-term surgical complications ileus and incisional hernia and of the impact of appendicitis and appendectomy on female fertility. Read More

J Proteome Res 2018 Dec 3. Epub 2018 Dec 3.

Cystic fibrosis (CF) is a complex multi-organ disorder that is among the most common fatal genetic diseases benefiting from therapeutic interventions early in life. Newborn screening (NBS) for pre-symptomatic detection of CF currently relies on a two-stage immunoreactive trypsinogen (IRT) and cystic fibrosis transmembrane conductance regulator (CFTR) mutation panel algorithm that is sensitive, but not specific for identifying affected neonates with a low positive predictive value. For the first time, we report the discovery of a panel of CF-specific metabolites from a single 3. Read More

J Med Radiat Sci 2018 Dec;65(4):250-251

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore.

This editorial is discussing about the indiscriminate use of abdominal radiographs in the emergency department in general, with focus on value of the erect abdominal radiograph for the diagnosis of mechanical bowel obstruction and paralytic ileus. Read More

J Neurogastroenterol Motil 2018 Nov 19. Epub 2018 Nov 19.

Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.

Post-operative ileus (POI) is an inevitable consequence of major abdominal surgery, and may be prolonged in up to 30% of patients. Ileus is commonly presumed to result from paralysis of the GI tract, though there is little direct evidence to support this view. The aim of this review is to systematically search and critically review the literature investigating post-operative colonic electrical and mechanical activity. Read More

J Surg Res 2019 Jan 3;233:249-255. Epub 2018 Sep 3.

Department of Surgery, Vivantes Hospital Neukölln, Berlin, Germany.

Background: Small bowel obstruction (SBO) is one of the most common disorders in surgical emergency departments. Without resolution of the obstructed bowel segments, patients may develop multiorgan failure. The aim of this study was to investigate whether morphological damage of the intestinal wall during SBO may lead to molecular translocation and how this may impair intestinal motility. Read More

Ostomy Wound Manage 2018 Dec;64(12):30-35

Princess Royal University Hospital, King's College NHS Foundation Trust, Orpington, UK.

The optimal timing of loop ileostomy reversal remains largely unknown, but evidence that delayed ileostomy closure may increase postoperative complication rates is increasing.

Purpose: Retrospective research was conducted to compare outcomes between patients who had early (<6 months) or late (>6 months) loop ileostomy closure.

Methods: Records of patients >18 years of age who underwent circumstomal reversal of a loop ileostomy over a period of 5 years in 1 hospital's colorectal unit were abstracted and analyzed. Read More

Am J Surg 2018 Nov 27. Epub 2018 Nov 27.

Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address:

Background: The aim of this study was to assess outcomes of octogenarians undergoing emergency abdominal surgery (EAS).

Methods: Octogenarians undergoing EAS 12/2011-12/2016 were retrospectively analysed. The outcomes were assessed by univariable and multivariable regression analysis. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13446

Department of General and Gastroenterological Surgery, Osaka Medical College, Daigaku-machi, Takatsuki.

Rationale: Liposarcoma (LPS) is a rare malignant soft-tissue tumor. Management of LPS is relatively difficult, because there are no characteristic symptoms, or biomarkers, nor any established effective treatment. Hence, the report of the accumulation of each LPS case is necessary. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13403

Rationale: Nonocclusive mesenteric ischemia (NOMI) is a life-threatening disorder; prompt diagnosis is vital. Surgical treatment is often required, but some cases can be treated conservatively. We herein report an extremely rare case wherein protein-losing enteropathy (PLE) developed after conservative treatment of NOMI. Read More

BMC Nephrol 2018 Nov 29;19(1):341. Epub 2018 Nov 29.

Division of Nephrology, Shimane University Hospital, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan.

Background: Peritoneal dialysis (PD)-associated infection caused by Mycobacterium spp. is rare. Mycobacterium abscessus is one of the most resistant acid-fast bacteria, and treatment is also the most difficult and refractory. Read More

Sci Rep 2018 Nov 26;8(1):17349. Epub 2018 Nov 26.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Coffee is believed to prevent postoperative ileus. This systematic review and meta-analysis was undertaken to determine the effectiveness of coffee consumption in stimulating gastrointestinal function after abdominal surgery. A number of databases for randomized controlled trials comparing coffee consumption following abdominal surgery versus water drinking or no intervention were searched. Read More

Am J Case Rep 2018 Nov 27;19:1410-1415. Epub 2018 Nov 27.

Vascular Surgery Clinic, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

BACKGROUND Splenic aneurysms are rare, asymptomatic, and usually derive from previous surgical interventions. Endovascular repair is the best option, but when A-V shunt is present, open repair might be more suitable. CASE REPORT A 43-year-old man presented to the Internal Medicine Department of AHEPA University Hospital with symptoms of fever and ascites. Read More

J Oncol Pharm Pract 2018 Nov 26:1078155218815305. Epub 2018 Nov 26.

2 Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Systemic light-chain (AL) amyloidosis is a rare hematologic disorder where proteins infiltrate tissues leading to organ failure and death. Cardiac involvement, present in ∼70% of patients, determines stage and prognosis of the disease, with advanced involvement having a median survival of six months. The treatment of light-chain amyloidosis is directed at recovering organ function with therapeutic strategies following those of multiple myeloma with plasma cell-directed therapies. Read More

JAMA Surg 2018 Nov 21. Epub 2018 Nov 21.

Section of Emergency General Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.

Importance: The Hartmann procedure (end colostomy) remains a common operation for diverticulitis requiring surgery. However, the timing of subsequent colostomy reversal remains widely varied, and the optimal timing remains unknown.

Objective: To investigate the association of the timing of colostomy reversal with operative outcomes. Read More

Gut 2018 Nov 24. Epub 2018 Nov 24.

Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for GastroIntestinal Disorders, Intestinal Neuroimmune Interactions, University of Leuven, Leuven, Belgium.

Objectives: Vagus nerve stimulation (VNS), most likely via enteric neurons, prevents postoperative ileus (POI) by reducing activation of alpha7 nicotinic receptor (α7nAChR) positive macrophages (mMφ) and dampening surgery-induced intestinal inflammation. Here, we evaluated if 5-HT4 receptor (5-HT4R) agonist prucalopride can mimic this effect in mice and human.

Design: Using Ca imaging, the effect of electrical field stimulation (EFS) and prucalopride was evaluated in situ on mMφ activation evoked by ATP in jejunal tissue. Read More

Int Urol Nephrol 2018 Nov 21. Epub 2018 Nov 21.

Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China.

Background: This study aimed to systematically summarize and analyze the current evidence regarding the effect of total parenteral nutrition (TPN) versus early enteral nutrition (EEN) on postoperative outcomes of cystectomy.

Methods: A comprehensive search of online databases was conducted to identify comparative studies on the postoperative outcomes of patients receiving TPN and EEN after cystectomy. Our subsequent meta-analysis followed the PRISMA Protocol and the Cochrane Handbook. Read More

PLoS One 2018 21;13(11):e0207099. Epub 2018 Nov 21.

Department of Internal Medicine, Saga Medical School, Saga, Japan.

Background: Small bowel obstruction (SBO) is usually caused by postoperative adhesions and malignant disease, and decompression is effective for SBO. Our previous case report suggested that a new transnasal ileus tube insertion method, the anterior balloon method (ABM), could achieve decompression for adhesive SBO.

Aims: The study aimed to investigate the effectiveness of a new method for inserting transnasal ileus tubes in patients with SBO. Read More

Turk J Gastroenterol 2018 Nov 16. Epub 2018 Nov 16.

Department of General Surgery, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey.

CNS Drugs 2018 Nov 19. Epub 2018 Nov 19.

Department of Psychological Medicine, University of Otago, PO Box 7343, Wellington, 6242, New Zealand.

Background: Gastrointestinal hypomotility in people taking clozapine is common, poorly understood and potentially dangerous. It causes distress and sometimes sudden death, with greater associated morbidity than the better known adverse effect of clozapine, agranulocytosis. Neither the mechanism nor prevalence of clozapine-induced gastrointestinal hypomotility is well understood. Read More

Surg Case Rep 2018 Nov 19;4(1):135. Epub 2018 Nov 19.

Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Background: Diaphragmatic hernias (DH) are generally classified as either congenital or acquired. Acquired DH are generally of traumatic cause, being a rare complication after hepatectomy. Although repair of a DH can be performed via laparotomy, laparoscopy, or thoracoscopy, the use of laparoscopy is rare after hepatectomy owing to the formation of scar tissue. Read More

Am Surg 2018 Feb;84(2):e89-e90

Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Neuromodulation 2018 Nov 19. Epub 2018 Nov 19.

Faculty of Medical and Health Sciences, Department of Surgery, The University of Auckland, Auckland, New Zealand.

Objectives: Postoperative ileus occurs in approximately 5-15% of patients following major abdominal surgery, and poses a substantial clinical and economic burden. Electrical stimulation has been proposed as a means to aid postoperative gastrointestinal (GI) recovery, but no methods have entered routine clinical practice. A systematic review was undertaken to assess electrical stimulation techniques and to evaluate their clinical efficacy in order to identify promising areas for future research. Read More

Med J Armed Forces India 2018 Oct 26;74(4):371-373. Epub 2017 Jul 26.

Medical Officer (Radiodiagnosis), Military Hospital Allahabad, UP 211001, India.

J Obstet Gynaecol Can 2018 Nov 12. Epub 2018 Nov 12.

Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB; Obstetrics and Gynecology, Foothills Medical Centre, Calgary, AB. Electronic address:

There is an increasing body of evidence to support the success of Enhanced Recovery After Surgery (ERAS) for a wide range of surgical procedures. There has been little formalized application, however, of ERAS principles in obstetrical surgery. The aim of this review was to examine the evidence base of perioperative care for patients undergoing CD and to determine the feasibility of developing an ERAS Society guideline for this obstetrical care plan. Read More

Rozhl Chir 2018 ;97(8):384-393

Introduction: Gastric resections due to carcinoma belong to the most demanding procedures in visceral surgery. This is due to the requirements for the extent of resection and lymphadenectomy, coupled with the need for functional reconstruction of the digestive tract. The procedure is associated with 18-46% morbidity, which delays administration of adjuvant therapy and worsens oncological results. Read More

Nutrients 2018 Nov 14;10(11). Epub 2018 Nov 14.

Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

Early re-alimentation is advocated by enhanced recovery pathways (ERP). This study aimed to assess compliance to ERP-set early re-alimentation policy and to compare outcomes of early fed patients and patients in whom early feeding was withhold due to the independent decision making of the surgeon. For this purpose, demographic, surgical and outcome data of all consecutive elective colorectal surgical procedures (2011⁻2016) were retrieved from a prospectively maintained institutional ERP database. Read More

JBI Database System Rev Implement Rep 2018 Nov;16(11):2072-2079

Department of Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan.

Review Question/objective: The purpose of this systematic review is to critically appraise, synthesize and present the best available evidence concerning the effects of coffee on postoperative ileus following abdominal surgery. The review will consider the effect of coffee and decaffeinated coffee on recovering gastrointestinal function, time to first bowel movement, time to first flatus, time to tolerance of solid food, postoperative complications and length of hospital stay. Read More

Medicine (Baltimore) 2018 Nov;97(46):e13140

Department of General Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

This study was undertaken to explore the causes, diagnosis, and treatment of anastomotic leakage after pull-through (PT) procedure for Hirschsprung disease (HD).A retrospective analysis of patients with anastomotic leakage after a PT procedure in the General Surgery Department of Beijing Children's Hospital from July 2013 to June 2016 was undertaken. The surgical characteristics, diagnosis, and treatment were retrospectively analyzed. Read More

J Invest Surg 2018 Nov 15:1-7. Epub 2018 Nov 15.

b Department of Neurosurgery , Jinling Hospital , Nanjing , China.

Frailty is characterized by a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of age-related decline in many physiological systems during a lifetime. To access the association between frailty and delayed recovery of gastrointestinal function in patients undergoing elective colorectal cancer resections, 241 patients who had undergone elective colorectal cancer resections from July 2015 to August 2017 were investigated. The association of frailty with delayed recovery of gastrointestinal function, length of stay (LOS), and whether or not to transfer into intensive care unit (ICU) were analyzed. Read More

Br J Dermatol 2018 Nov 15. Epub 2018 Nov 15.

Service de Réanimation Médicale, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique - Hôpitaux de Paris (AP-HP), Créteil, France.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are characterized by extensive skin and mucosal membrane detachment together with specific visceral involvement. While respiratory tract and ear, nose, and throat mucosal lesions have been comprehensively described, gastro-intestinal (GI) involvement, although previously reported, has been less investigated. Clinical manifestations are non-specific, including ileus, emesis, diarrhea, hematemesis, melena/rectal bleeding, abdominal pain, or dysphagia. Read More

Surg Endosc 2018 Nov 13. Epub 2018 Nov 13.

Department of General Surgery, Virgen de la Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain.

Background: Right hemicolectomy is a very common surgery. Many studies compare different options for laparoscopic ileocolic anastomoses: intra- or extracorporeal; handsewn or stapled; side-to-side or end-to-side. However, there are no studies about the influence that peristalsis could have on this anastomosis. Read More

J Am Med Dir Assoc 2018 Nov 10. Epub 2018 Nov 10.

Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts.

Objective: To evaluate the effects of the modified Hospital Elder Life Program (mHELP) comprising 3 nurse-administered protocols in older patients undergoing gastrointestinal (GI) surgery.

Design: Cluster randomized trial.

Setting: Two 36-bed GI wards at a university-affiliated medical center in Taiwan. Read More

Am J Ther 2018 Oct 26. Epub 2018 Oct 26.

Pharmacy Department, Division of Medicines, Hospital Clinic Barcelona, Universitat de Barcelona, Spain.

Clin Auton Res 2018 Nov 10. Epub 2018 Nov 10.

Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Via Tesserete, 48, 6900, Lugano, Switzerland.

Int J Surg 2018 Nov 9;60:113-119. Epub 2018 Nov 9.

Department of Gastrointestinal Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address:

Background: Trans-anal total mesorectal resection (TaTME) is a novel approach for rectal cancer. However, the perioperative and pathological outcomes of this procedure remain controversial.

Method: A systematic literature search was performed using PubMed, Embase, Wanfang (China) and the Cochrane Library databases without restriction to regions or languages. Read More

Colorectal Dis 2018 Nov 8. Epub 2018 Nov 8.

Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland.

Aim: The present study aimed to analyse fluid management and to define optimal fluid-related thresholds for elective open colorectal surgery.

Method: A retrospective analysis was made of all consecutive elective open colorectal resections performed in our tertiary centre between May 2011 and May 2017. The main outcomes were postoperative complications [overall (I-V) and severe (IIIB-V) according to the Clavien classification], respiratory complications and postoperative ileus (POI). Read More

Medicine (Baltimore) 2018 Nov;97(45):e13097

Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.

Background: Perioperative goal-directed fluid therapy (GDFT) aiming to maintain individual fluid balance based on sensitive parameters was prevalent in major surgery, especially in enhanced recovery after surgery (ERAS) pathway. This meta-analysis was conducted for the purpose of evaluating whether GDFT impacts on occurrence of postoperative ileus and whether its application is worthwhile in gastrointestinal surgery.

Methods: A systematic search of RCTs compared GDFT with other fluid management in patients undergoing gastrointestinal surgery from the PubMed, Web of Science, Embase, Cochrane Library databases was implemented. Read More

Neurogastroenterol Motil 2018 Nov 8:e13501. Epub 2018 Nov 8.

Department of Surgery, University of Bonn, Bonn, Germany.

Background: The cholinergic anti-inflammatory pathway comprises the perception of peripheral inflammation by afferent sensory neurons and reflex activation of efferent vagus nerve activity to regulate inflammation. Activation of this pathway was shown to reduce the inflammatory response and improve outcome of postoperative ileus (POI) and sepsis in rodents. Herein, we tested if a non-invasive auricular electrical transcutaneous vagus nerve stimulation (tVNS) affects inflammation in models of POI or endotoxemia. Read More

J Endourol 2018 Nov 6. Epub 2018 Nov 6.

Hokkaido University Hospital, Urology, Sapporo, Japan ;

Introduction: Laparoscopic surgery has been a standard procedure of living donor nephrectomy. Transperitoneal hand-assisted laparoscopic living donor nephrectomy (HALDN) has been commonly reported by many centers with excellent outcome. However, there are few studies reporting retroperitoneoscopic living donor nephrectomy (RPLDN). Read More

J Gastrointest Surg 2018 Nov 2. Epub 2018 Nov 2.

Department of Medicine, Division of Gastroenterology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA.

Background: Passage of flatus after abdominal surgery signals resolution of physiological postoperative ileus (POI) and often, particularly after complex open surgeries, serves as the trigger to initiate oral feeding. To date, there is no objective tool that can predict time to flatus allowing for timely feeding and optimizing recovery. In an open, prospective study, we examine the use of a noninvasive wireless patch system that measures electrical activity from gastrointestinal smooth muscles in predicting time to first flatus. Read More