1,903 results match your criteria Intra-abdominal Sepsis


Robotic surgery in infants and children: an argument for smaller and fewer incisions.

World J Urol 2019 Apr 23. Epub 2019 Apr 23.

Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Purpose: Robotic-assisted laparoscopic (RAL) surgery has gained momentum in pediatric urology. Technological adaptations such as the development of 5 mm instruments have led to robotic procedures being performed on younger children and those having smaller body habitus, with improved cosmesis. However, concerns have been raised regarding decreased intra-abdominal working space and the absence of monopolar curved scissors (hot endoshears) when using 5 mm instruments. Read More

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http://dx.doi.org/10.1007/s00345-019-02765-zDOI Listing

The Duration of Intra-abdominal Hypertension and Increased Serum Lactate Level are Important Prognostic Markers in Critically Ill Surgical Patient's Outcome: A Prospective, Observational Study.

Niger J Surg 2019 Jan-Jun;25(1):1-8

Department of General Surgery, J.L.N Medical College, Ajmer, Rajasthan, India.

Aim: The present study analyzed the clinical significance of duration of intra-abdominal hypertension (IAH) associated with increased serum lactate in critically ill patients with severe sepsis.

Materials And Methods: Our study was an observational, prospective study carried out in the Surgical Intensive Care Unit (ICU) at J.L. Read More

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http://dx.doi.org/10.4103/njs.NJS_7_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452757PMC
April 2019
2 Reads

The time-controlled adaptive ventilation protocol: mechanistic approach to reducing ventilator-induced lung injury.

Eur Respir Rev 2019 Jun 17;28(152). Epub 2019 Apr 17.

Dept of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.

Airway pressure release ventilation (APRV) is a ventilator mode that has previously been considered a rescue mode, but has gained acceptance as a primary mode of ventilation. In clinical series and experimental animal models of extrapulmonary acute respiratory distress syndrome (ARDS), the early application of APRV was able to prevent the development of ARDS. Recent experimental evidence has suggested mechanisms by which APRV, using the time-controlled adaptive ventilation (TCAV) protocol, may reduce lung injury, including: 1) an improvement in alveolar recruitment and homogeneity; 2) reduction in alveolar and alveolar duct micro-strain and stress-risers; 3) reduction in alveolar tidal volumes; and 4) recruitment of the chest wall by combating increased intra-abdominal pressure. Read More

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http://err.ersjournals.com/lookup/doi/10.1183/16000617.0126-
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http://dx.doi.org/10.1183/16000617.0126-2018DOI Listing
June 2019
2 Reads

Assessment of clinical and epidemiological characteristics of patients with and without sepsis in intensive care units of a tertiary hospital.

Einstein (Sao Paulo) 2019 15;17(2):eAO4476. Epub 2019 Apr 15.

Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.

Objective: To describe the clinical and epidemiological features of patients with and without sepsis at critical care units of a public hospital.

Methods: A cross-sectional study was carried out from May 2012 to April 2013. Clinical and laboratory data of patients with and without sepsis in the intensive care units were reviewed of medical records. Read More

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http://dx.doi.org/10.31744/einstein_journal/2019AO4476DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459321PMC

Portal pyaemia secondary to colonic perforation.

BMJ Case Rep 2019 Apr 15;12(4). Epub 2019 Apr 15.

Department of Hepatopancreaticobiliary Surgery, Cambridge University Hospital, Cambridge, Cambridgeshire, UK.

Portal pyaemia or pylephlebitis is a form of septic (often suppurative) thrombophlebitis of the portal venous system. It may develop as a complication of intra-abdominal sepsis, such as diverticulitis or appendicitis. Patients typically present with a high fever that is sometimes accompanied by jaundice. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2018-22840
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http://dx.doi.org/10.1136/bcr-2018-228400DOI Listing
April 2019
2 Reads

oXiris® Use in Septic Shock: Experience of Two French Centres.

Blood Purif 2019 12;47 Suppl 3:1-7. Epub 2019 Apr 12.

Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.

Background: Sepsis is a dysregulated host response to an infection and can result in organ dysfunctions and death. Extracorporeal blood purification techniques aim to improve the prognosis of these patients by modulating the unbalanced immune response. This study reports our experience with the use of the oXiris® membrane for septic shock patients requiring continuous renal replacement therapy (CRRT). Read More

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http://dx.doi.org/10.1159/000499510DOI Listing
April 2019
1 Read

The role of the intra-abdominal view in complicated intra-abdominal infections.

World J Emerg Surg 2019 29;14:15. Epub 2019 Mar 29.

1Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland.

Background: The prognostic role of what a surgeon observes in the abdomen of patients with complicated intra-abdominal infection (cIAI) is largely unknown. The aim of this prospective study was to systemically analyze components of the intra-abdominal view (IAV) and their association to severe complicated intra-abdominal sepsis (SCIAS) or mortality.

Methods: The study cohort consisted of adult patients with cIAI. Read More

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http://dx.doi.org/10.1186/s13017-019-0232-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441193PMC
March 2019
1 Read

Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia.

Rev Bras Ter Intensiva 2019 Jan-Mar;31(1):47-56

Grupo Académico de Epidemiología Clínica, Universidad de Antioquia - Medellín, Colombia.

Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department.

Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Read More

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http://dx.doi.org/10.5935/0103-507X.20190011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443304PMC
August 2018
1 Read

Outcome of 150 Consecutive Blumgart's Pancreaticojejunostomy After Pancreaticoduodenectomy.

Indian J Surg Oncol 2019 Mar 27;10(1):65-71. Epub 2018 Oct 27.

1Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. 221005 India.

Postoperative pancreatic fistula (POPF) is the most feared complication after pancreaticoduodenectomy (PD) that leads to intra-abdominal abscess, sepsis, or bleeding and remains the single most important source of morbidity and mortality after PD. To minimize this dreaded complication, various surgical techniques and modifications of pancreaticoenteric reconstruction have been proposed. However, still POPF does occur even in experienced hands. Read More

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http://dx.doi.org/10.1007/s13193-018-0821-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414584PMC
March 2019
1 Read

Cytokines and Chemokines in Pediatric Appendicitis: A Multiplex Analysis of Inflammatory Protein Mediators.

Mediators Inflamm 2019 21;2019:2359681. Epub 2019 Feb 21.

Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary AB, Canada.

Objectives: We aimed to demonstrate the potential of precision medicine to describe the inflammatory landscape present in children with suspected appendicitis. Our primary objective was to determine levels of seven inflammatory protein mediators previously associated with intra-abdominal inflammation (C-reactive protein-CRP, procalcitonin-PCT, interleukin-6 (IL), IL-8, IL-10, monocyte chemoattractant protein-1-MCP-1, and serum amyloid A-SAA) in a cohort of children with suspected appendicitis. Subsequently, using a multiplex proteomics approach, we examined an expansive array of novel candidate cytokine and chemokines within this population. Read More

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http://dx.doi.org/10.1155/2019/2359681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409077PMC
February 2019
1 Read

Vedolizumab in the perioperative management of inflammatory bowel disease.

Curr Drug Targets 2019 Mar 25. Epub 2019 Mar 25.

Division of Gastroenterology, Mayo Clinic, Rochester, Minnesota. United States.

Background: The isolated effect of vedolizumab on increased postoperative complications remains debated, similar to the controversial data on anti-TNF and postoperative complications.

Objective: Determine the risk of vedolizumab on postoperative complications.

Method: A review of the literature available to date on studies comparing postoperative outcomes in vedolizumab-treated versus non-vedolizumab-treated patients was performed. Read More

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http://dx.doi.org/10.2174/1389450120666190325130142DOI Listing
March 2019
1 Read

Laparoscopy-induced severe renal failure after appendectomy.

J Surg Case Rep 2019 Mar 21;2019(3):rjz079. Epub 2019 Mar 21.

Colorectal Surgery Department, University Hospital Donostia, San Sebastian, Spain.

Laparoscopy has gained importance in the abdominal emergency surgery field. Acute appendicitis is one of the major indications for emergency surgery, being laparoscopy the gold standard approach. We report a case of a 39-years-old female presenting with acute kidney injury (AKI) after laparoscopy. Read More

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http://dx.doi.org/10.1093/jscr/rjz079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428156PMC
March 2019
1 Read

Efficacy of Coupled Plasma Filtration Adsorption in Treating Patients with Severe Intra-Abdominal Infection: A Retrospective Study.

J Laparoendosc Adv Surg Tech A 2019 Mar 15. Epub 2019 Mar 15.

Department of General Surgery, Jinling Clinical College of Nanjing Medical University, Nanjing, China.

Background: Coupled plasma filtration adsorption (CPFA) is an extracorporeal treatment based on plasma filtration associated with an adsorbent cartridge and hemofiltration. CPFA is able to remove inflammatory mediators and it has been used to treat severe sepsis and multiple organ dysfunction. Limited experience exists on the use of CPFA in treating intra-abdominal infection (IAI). Read More

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http://dx.doi.org/10.1089/lap.2018.0792DOI Listing
March 2019
1 Read

Spontaneous perforation of small intestine followed by rupture of the cystic artery: the natural history of Vascular Ehlers-Danlos Syndrome.

Autops Case Rep 2019 Jan-Mar;9(1):e2018054. Epub 2019 Jan 17.

Mount Sinai Medical Center, AM Rywlin MD Department of Pathology and Laboratory Medicine. Miami Beach, FL, United States of America.

Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant disorder caused by mutations in the or genes. Its mortality is secondary to sudden and spontaneous rupture of arteries or hollow organs. The genotype influences the distribution of arterial pathology with aneurysms of intra-abdominal visceral arteries being relatively uncommon. Read More

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http://www.autopsyandcasereports.org/article/doi/10.4322/acr
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http://dx.doi.org/10.4322/acr.2018.054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394365PMC
January 2019
8 Reads

Novel Chitohexaose Analog Protects Young and Aged mice from CLP Induced Polymicrobial Sepsis.

Sci Rep 2019 Feb 27;9(1):2904. Epub 2019 Feb 27.

AyuVis Research Inc, 1120 South Freeway, Fort Worth, TX, 76104, USA.

In Gram-negative bacterial sepsis, production of excess pro-inflammatory cytokines results in hyperinflammation and tissue injury. Anti-inflammatory cytokines such as IL-10 inhibit inflammation and enhance tissue healing. Here, we report a novel approach to treat septicemia associated with intra-abdominal infection in a murine model by delicately balancing pro- and anti-inflammatory cytokines. Read More

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http://www.nature.com/articles/s41598-019-38731-3
Publisher Site
http://dx.doi.org/10.1038/s41598-019-38731-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393422PMC
February 2019
6 Reads
5.078 Impact Factor

[Clinical trials of acupuncture of Jiaji (EX-B2) for treatment of gastrointestinal dysfunction in sepsis patients].

Zhen Ci Yan Jiu 2019 Jan;44(1):43-6

Intensive Care Unit, Changxing County Hospital of Traditional Chinese Medicine, Huzhou 313000, Zhejiang Province, China.

Objective: To observe the clinical therapeutic effect of acupuncture of Huatuo Jiaji (EX-B2) in the treatment of gastrointestinal dysfunction in sepsis patients, aiming at providing new clinical approach and evidence for improving septic gastrointestinal activity.

Methods: A total of 40 patients with septic gastrointestinal dysfunction who met our inclusive criteria were randomly divided into control group and treatment group (=20 cases in each). Patients in the control group received routine treatment of nasogastric mosapride citrate (5 mg/time, three times a day) and tifidobacterium triple viable capsules (420 mg, twice a day), intravenous infusion of omeprazole (40 mg, twice a day), rational dose of antibiotics, maintenance treatment of functions of the heart, lung, brain, kidney and other important organs and water electrolyte balance, as well as symptomatic treatment. Read More

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http://dx.doi.org/10.13702/j.1000-0607.170579DOI Listing
January 2019
1 Read

The Influence of Preoperative Medications on Postoperative Complications in Patients After Intestinal Surgery for Crohn's Disease.

Inflamm Bowel Dis 2019 Feb 8. Epub 2019 Feb 8.

Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Background: Many patients with Crohn's disease (CD) are treated with medications, including steroids, immunomodulators, and anti-tumor necrosis factor alpha (anti-TNF-α) agents, at the time of surgery. This study evaluated the effects of these medications on postoperative complications in CD patients.

Methods: This retrospective study analyzed patients who underwent bowel resection for CD between January 2006 and December 2015. Read More

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http://dx.doi.org/10.1093/ibd/izz010DOI Listing
February 2019
11 Reads
4.464 Impact Factor

Intra- abdominal sepsis from a perforated duodenal ulcer-Management of a difficult surgical abdomen.

Int J Surg Case Rep 2019 1;55:171-173. Epub 2019 Feb 1.

Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.

Introduction: Peptic ulcer perforation is a common surgical emergency that is a complication of 9% of patients with peptic ulcer disease (Kjetil et al., 2015 [1]). Despite advances in the management of peptic ulcer disease, the number of acute complications have remained constant. Read More

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http://dx.doi.org/10.1016/j.ijscr.2019.01.033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369133PMC
February 2019
3 Reads

Hyponatremia could identify patients with intrabdominal sepsis and anastomotic leak after colorectal surgery: a systematic review of the literature.

Updates Surg 2019 Mar 8;71(1):17-20. Epub 2019 Feb 8.

Department of Colorectal Surgery, Chelsea and Westminster Hospital, 369 Fulham Rd, London, SW10 9NH, UK.

Anastomotic leak (AL) is a serious post-operative complication in colorectal surgery. It can lead to devastating morbidity and mortality. Clinicians usually depend on a combination of clinical, biochemical and radiological findings to diagnose this problem. Read More

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http://dx.doi.org/10.1007/s13304-019-00627-2DOI Listing
March 2019
2 Reads

Pleural empyema in a patient with a perinephric abscess and diaphragmatic defect.

Respirol Case Rep 2019 Apr 29;7(3):e00400. Epub 2019 Jan 29.

Department of Respiratory Medicine Sir Charles Gairdner Hospital Nedlands Western Australia Australia.

Pleural infection as a complication of ascending urological infection is rare, and the mechanism often unclear. We report a complicated case of pleural infection and perinephric abscess in a patient who presented with a large right-sided pleural effusion. Pleural fluid culture yielded , an unusual pathogen in pleuro-pulmonary infections. Read More

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http://dx.doi.org/10.1002/rcr2.400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350234PMC
April 2019
3 Reads

Disseminated intestinal basidiobolomycosis with mycotic aneurysm mimicking obstructing colon cancer.

BMJ Case Rep 2019 Jan 29;12(1). Epub 2019 Jan 29.

Department of General Surgery, Ministry of Health, Dammam, Eastern Province, Saudi Arabia.

Basidiobolomycosis is a rare fungal infection that may affect the gastrointestinal tract. It is caused by and less than 80 cases have been reported in the literature. The incidence seems to be higher in the Middle East and in particular Saudi Arabia where most cases are diagnosed in the south-western region. Read More

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http://dx.doi.org/10.1136/bcr-2018-225054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352788PMC
January 2019
3 Reads

Intra-abdominal sepsis: new definitions and current clinical standards.

Langenbecks Arch Surg 2019 Jan 26. Epub 2019 Jan 26.

Medical Clinic II, University Hospital of Giessen, Giessen, Germany.

Purpose: The abdomen is the second most common source of sepsis and is associated with unacceptably high morbidity and mortality. Recently, the essential definitions of sepsis and septic shock were updated (Third International Consensus Definitions for Sepsis and Septic Shock, Sepsis-3) and modified. The purpose of this review is to provide an overview of the changes introduced by Sepsis-3 and the current state of the art regarding the treatment of abdominal sepsis. Read More

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http://dx.doi.org/10.1007/s00423-019-01752-7DOI Listing
January 2019
4 Reads

Endoluminal Vacuum Therapy: How I Do It.

J Gastrointest Surg 2019 May 22;23(5):1037-1043. Epub 2019 Jan 22.

Center for Advanced Surgery, Baylor Scott and White Health, 3417 Gaston Avenue, Suite 1000 East, Dallas, TX, 75246, USA.

Perforations and leaks of the gastrointestinal tract are difficult to manage and are associated with high morbidity and mortality. Recently, endoscopic approaches have been applied with varying degrees of success. Most recently, the use of endoluminal vacuum therapy has been used with high success rates in decreasing both morbidity and mortality. Read More

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http://dx.doi.org/10.1007/s11605-018-04082-zDOI Listing
May 2019
3 Reads

Concise Commentary: The Clot Thickens-Why Pylephlebitis Is One of the Most Feared Complications of Intra-abdominal Sepsis.

Authors:
Jonathan G Stine

Dig Dis Sci 2019 Jan 2. Epub 2019 Jan 2.

Division of Gastroenterology and Hepatology, Department of Medicine, and Department of Public Health Sciences, The Pennsylvania State University Milton S. Hershey Medical Center, Hershey, PA, USA.

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http://dx.doi.org/10.1007/s10620-018-5440-6DOI Listing
January 2019
1 Read

Does retrieval bag use during laparoscopic appendectomy reduce postoperative infection?

Surgery 2018 Dec 24. Epub 2018 Dec 24.

Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address:

Background: Appendectomy is the most commonly performed emergency operation in the United States, with approximately 370,000 patients undergoing the procedure every year. Although laparoscopic appendectomy is associated with decreased complications when compared with open appendectomy, the risk for infectious complications, including surgical site infection, intra-abdominal abscess, and sepsis, remains a significant source of postoperative morbidity and health care cost. The goal of this study is to determine whether the appendix retrieval technique during laparoscopic appendectomy affects risk of infectious complications. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00396060183079
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http://dx.doi.org/10.1016/j.surg.2018.11.012DOI Listing
December 2018
8 Reads

[Research progress of the open abdomen in the treatment of gastrointestinal fistula with complicated intra-abdominal infection].

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Dec;21(12):1446-1450

Department of Digestive Surgery, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, The Airforce Medical University, Xi'an 710032, China, Email: edu.cn.

Gastrointestinal fistula patients may suffer from complicated intra-abdominal infection and sepsis with improper treatment, which is characterized by high mortality ranging from 20% to 60%, as well as high medical costs. Gastrointestinal fistula patients with complicated intra-abdominal infections are not often diagnosed early, and proper treatment remains an unsolved problem. Therefore it is a great challenge for surgeons to repair broken intestines under complicated intra-abdominal infection conditions and to repair ruptured intestines under conditions of severe abdominal adhesions and swelling of the intestinal wall and mesentery. Read More

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December 2018
3 Reads

Extra-Anatomic Stents in Ureteric Obstruction: Our Experience.

J Endourol 2019 Mar 1;33(3):242-247. Epub 2019 Feb 1.

1 Department of Urology, Guy's and St Thomas' Hospitals, London, United Kingdom.

Objectives: To present our experience of the Detour extra-anatomic stent (EAS; Porges-Coloplast, Denmark) to bypass ureteric obstruction. Use of the EAS is indicated in patients with complex ureteric strictures or malignant disease, where long-term nephrostomy drainage is undesirable.

Materials And Methods: Between December 2001 and October 2017, 20 Detour EAS were implanted into 13 patients. Read More

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https://www.liebertpub.com/doi/10.1089/end.2018.0610
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http://dx.doi.org/10.1089/end.2018.0610DOI Listing
March 2019
12 Reads

Is intra-abdominal hypertension a risk factor for ventilator-associated pneumonia?

Ann Transl Med 2018 Nov;6(21):419

Department of Critical Care Medicine, University Hospital of Larisa, University of Thessaly School of Medicine, Larisa, Greece.

In the last years, there has been a significant amount of research about the impact of intra-abdominal hypertension (IAH) on the outcomes of critical care patients. IAH is increasingly recognized as potential complication in intensive care unit (ICU) patients. IAH affects all body systems, most notably the cardiac, respiratory, renal, and neurologic systems. Read More

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http://dx.doi.org/10.21037/atm.2018.08.27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275402PMC
November 2018
2 Reads

Abdominal Sepsis: An Update.

J Crit Care Med (Targu Mures) 2018 Oct 1;4(4):120-125. Epub 2018 Oct 1.

University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Târgu Mureş Romania.

Despite the significant development and advancement in antibiotic therapy, life-threatening complication of infective diseases cause hundreds of thousands of deaths world. This paper updates some of the issues regarding the etiology and treatment of abdominal sepsis and summaries the latest guidelines as recommended by the Intra-abdominal Infection (IAI) Consensus (2017). Prognostic scores are currently used to assess the course of peritonitis. Read More

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http://content.sciendo.com/view/journals/jccm/4/4/article-p1
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http://dx.doi.org/10.2478/jccm-2018-0023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296273PMC
October 2018
17 Reads

Systematic Review of Laparostomy/Open Abdomen to Prevent Acute Compartimental Syndrome (ACS).

Maedica (Buchar) 2018 Sep;13(3):179-182

Carlo Urbani Hospital, Jesi, Ancona, Italy.

Laparostomy is defined as a surgical technique in which the peritoneal cavity is opened and left open, called "open abdomen" (OA). An open abdomen presents numerous challenges for the clinician. Specific pathologies like severe intraabdominal sepsis, trauma requiring damage control, abdominal compartment syndrome, staged abdominal repair and other complex abdominal pathologies can be managed with laparostomy. Read More

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http://dx.doi.org/10.26574/maedica.2018.13.3.179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290176PMC
September 2018
2 Reads

Unexpected source of bacteraemia.

BMJ Case Rep 2018 Dec 3;11(1). Epub 2018 Dec 3.

Department of General Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia.

Mycotic (infected) aneurysm involving the thoracic aorta is an exceedingly rare and life-threatening condition that is associated with high morbidity and mortality. We report an unusual source of bacteraemia thought to be due to an infected aneurysm in the thoracic aortic arch in an elderly woman. Source of gram-negative bacteraemia is usually isolated to an intra-abdominal or a pelvic source. Read More

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http://dx.doi.org/10.1136/bcr-2018-226744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301452PMC
December 2018
7 Reads

Management of duodenal trauma: A retrospective review from the Panamerican Trauma Society.

J Trauma Acute Care Surg 2019 Mar;86(3):392-396

From the Virginia Commonwealth University (P.F., L.W., R.I.), Richmond, Virginia; Tulane University (J.D.), New Orleans, Louisiana; University of Campinas (G.P.F., B.M.P.), Campinas, Brazil; Keck School of Medicine (E.B., A.A.), University of Southern California, Los Angeles, California; University of San Francisco (A.C., C.W.), San Francisco, California; Clinical Research Center (A.G.), Fundación Valle del Lili, Cali, Colombia; Universidad de Antioquia-Hospital Universitario San Vicente Fundación (C.M.J.C.), Medellin, Colombia; Hospital Geral Grajaú-Universidade Santo Amaro (M.R.), São Paulo, Brazil; Hospital Santo Tomas (M.Q.), Cuidada de Panamá, Panamá; Robert Wood Johnson Medical School (G.P.); Hospital Vicente Corral Moscoso-Universidad del Azuay (J.C.S.), Cuenca, Ecuador; and Shock Trauma Centre (T.S.), University of Maryland, College Park, Maryland.

Introduction: The operative management of duodenal trauma remains controversial. Our hypothesis is that a simplified operative approach could lead to better outcomes.

Methods: We conducted an international multicenter study, involving 13 centers. Read More

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http://dx.doi.org/10.1097/TA.0000000000002157DOI Listing
March 2019
3 Reads

[Intra-abdominal infections. Update and recommendations].

Medicina (B Aires) 2018 ;78(6):417-426

Hospital Prof. Alejandro Posadas, El Palomar, Buenos Aires, Argentina.

Intra-abdominal infections represent a group of intra and retroperitoneal processes, ranging from localized infections to complicated ones, sepsis and septic shock, associated with a significant mortality rate. They are the third most commonly identified cause of sepsis and the second cause of death in the intensive care unit. Although antimicrobial therapy must be started as soon as possible, especially in critically ill patients, the source control procedure is highly relevant. Read More

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January 2018
11 Reads

Comparative genomics of transport proteins in seven Bacteroides species.

PLoS One 2018 5;13(12):e0208151. Epub 2018 Dec 5.

Department of Molecular Biology, Division of Biological Sciences, University of California at San Diego, La Jolla, CA, United States of America.

The communities of beneficial bacteria that live in our intestines, the gut microbiome, are important for the development and function of the immune system. Bacteroides species make up a significant fraction of the human gut microbiome, and can be probiotic and pathogenic, depending upon various genetic and environmental factors. These can cause disease conditions such as intra-abdominal sepsis, appendicitis, bacteremia, endocarditis, pericarditis, skin infections, brain abscesses and meningitis. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208151PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281302PMC
December 2018
4 Reads

Methods of conservative antibiotic treatment of acute uncomplicated appendicitis: A systematic review.

J Trauma Acute Care Surg 2019 Apr;86(4):722-736

From the Department of Emergency Medicine (D.A.T., G.J.M.); Division of Infectious Diseases (D.A.T., G.J.M.), Department of Medicine; Department of Surgery (D.J.S.), Olive View-UCLA Medical Center, Sylmar; and Department of Surgery (D.A.D.), Division of Pediatric Surgery, Harbor-UCLA Medical Center, Torrance, California.

Background: Meta-analyses and a recent guideline acknowledge that conservative management of uncomplicated appendicitis with antibiotics can be successful for patients who wish to avoid surgery. However, guidance as to specific management does not exist.

Methods: PUBMED and EMBASE search of trials describing methods of conservative treatment was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Read More

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http://dx.doi.org/10.1097/TA.0000000000002137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437084PMC
April 2019
2 Reads

Early Laparoscopic Washout may Resolve Persistent Intra-abdominal Infection Post-appendicectomy.

World J Surg 2019 Apr;43(4):998-1006

Department of Surgery, Nepean Hosptial, P. O. Box 67, Penrith, NSW, 2751, Australia.

Background: Intra-abdominal abscess (IAA) complicates 2-3% of patients having an appendicectomy. The usual management is prolonged antibiotics and drainage of the IAA. From 2006, our unit chose to use early re-laparoscopy and washout in patients with persistent sepsis following appendicectomy. Read More

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http://link.springer.com/10.1007/s00268-018-4871-8
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http://dx.doi.org/10.1007/s00268-018-4871-8DOI Listing
April 2019
16 Reads

Laparoscopic Repair for Perforated Peptic Ulcer Disease Has Better Outcomes Than Open Repair.

J Gastrointest Surg 2019 Mar 21;23(3):618-625. Epub 2018 Nov 21.

The Whiteley-Martin Research Centre, Discipline of Surgery, Nepean Hospital, The University of Sydney, Level 5, South Block, P.O. Box 63, Penrith, NSW, 2751, Australia.

Purpose: Over the last 3 decades, laparoscopic procedures have emerged as the standard treatment for many elective and emergency surgical conditions. Despite the increased use of laparoscopic surgery, the role of laparoscopic repair for perforated peptic ulcer remains controversial among general surgeons. The aim of this study was to compare the outcomes of laparoscopic versus open repair for perforated peptic ulcer. Read More

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http://dx.doi.org/10.1007/s11605-018-4047-8DOI Listing
March 2019
24 Reads

Outcomes of early relaparotomy in pediatric patients at Tikur Anbessa teaching hospital, Addis Ababa, Ethiopia: a five-year retrospective review.

BMC Surg 2018 Nov 16;18(1):99. Epub 2018 Nov 16.

Addis Ababa University, Addis Ababa, Ethiopia.

Background: Early relaparotomy is defined as relaparotomy within the first 30 days following surgery. The aim of this study is to explore the indications, outcomes and factors associated with relaparotomy in our pediatric population.

Methods: We performed a retrospective study of pediatric surgical patients (< 13 yrs. Read More

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http://dx.doi.org/10.1186/s12893-018-0436-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240246PMC
November 2018
3 Reads

[Clinical characteristics and predictors of mortality in patients with candidemia in intensive care unit].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Oct;30(10):929-932

Department of Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China (Zhao HY, Wu PH, Wang GJ, Wang HX, Zhu FX, An YZ); Department of Clinical Laboratory, Peking University People's Hospital, Beijing 100044, China (Wang Q). Corresponding author: An Youzhong, Email:

Objective: To investigate the clinical characteristics and predictors of mortality in patients with candidemia in intensive care unit (ICU).

Methods: The patients with candidemia admitted to ICU of Peking University People's Hospital from January 2010 to December 2017 were enrolled. The general clinical data, indicators related to Candidia infection and prognosis were collected, and the clinical characteristics, infection characteristics and prognosis of patients with candidiasis were analyzed. Read More

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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2018.010.004DOI Listing
October 2018
19 Reads

Robotic distal pancreatectomy with selective closure of pancreatic duct: surgical outcomes.

Updates Surg 2019 Mar 14;71(1):145-150. Epub 2018 Nov 14.

Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.

Pancreatic fistula is the main post-operative complication of distal pancreatectomy associated with other further complications, such as intra-abdominal abscesses, wound infection, sepsis, electrolyte imbalance, malabsorption and hemorrhage. Surgeons have tried various techniques to close the stump of the remaining pancreas, but the controversy regarding the impact of stapler closure and suture closure of the pancreatic stump is far from resolved. In this study, we reported our technique and results of robotic assisted distal pancreatectomy with ultrasound identification and consequent selective closure of pancreatic duct. Read More

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http://link.springer.com/10.1007/s13304-018-0605-6
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http://dx.doi.org/10.1007/s13304-018-0605-6DOI Listing
March 2019
16 Reads

Mortality and morbidity after pancreatoduodenectomy in patients undergoing hemodialysis: Analysis using a national inpatient database.

Surgery 2019 Apr 10;165(4):747-750. Epub 2018 Nov 10.

National Center for Global Health and Medicine, Tokyo, Japan.

Background: Whether patients undergoing hemodialysis have greater risks of mortality and morbidity after pancreatoduodenectomy remains unknown.

Methods: We used the Diagnosis Procedure Combination database, a national Japanese inpatient database, to identify patients who underwent pancreatoduodenectomy from July 2010 to March 2015. We conducted propensity-score-matching analyses to compare the outcomes, including postoperative complications and 30- and 90-day mortality after pancreatoduodenectomy between patients with and without hemodialysis. Read More

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http://dx.doi.org/10.1016/j.surg.2018.10.009DOI Listing
April 2019
8 Reads

A Double Whammy: Lactobacillus acidophilus Bacteremia and Subsequent Lactobacillus rhamnosus Prosthetic Valve Infective Endocarditis in an Elderly Diabetic Patient.

R I Med J (2013) 2018 Nov 1;101(9):32-35. Epub 2018 Nov 1.

Assistant Professor of Medicine, The Warren Alpert Medical School of Brown University, Department of Infectious Diseases, Providence VA Medical Center.

The clinical significance of the relatively avirulent organ- ism, Lactobacillus, has been debated in the past. At times misdiagnosed as a contaminant, Lactobacillus has uncommonly been reported to cause intra-abdominal abscesses, peritonitis, meningitis, bacteremia, pneumonia and endocarditis, especially in the population of patients with underlying comorbid conditions including malignancy, diabetes, recent surgery or organ transplantation. We report a case of a 74-year-old male with Lactobacillus bacteremia leading to prosthetic valve infective endocarditis complicated by an aortic root abscess. Read More

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November 2018
4 Reads

[Blunt abdominal trauma causing acute pancreatitis: presentation of the case study].

Pan Afr Med J 2018 13;30:126. Epub 2018 Jun 13.

Service des Urgences Hôpital Régional de Kasserin, Tunisie.

Acute pancreatitis is a serious disease having a guarded prognosis. Its etiology involves either bladder or alcohol. Traumatic origin is extremely rare and it is often associated with other intra-abdominal lesions. Read More

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http://www.panafrican-med-journal.com/content/article/30/126
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http://dx.doi.org/10.11604/pamj.2018.30.126.14675DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201622PMC
November 2018
15 Reads

Contrast radiography before diverting stoma closure in rectal cancer is not necessary on a routine basis.

Cir Esp 2019 Mar 19;97(3):145-149. Epub 2018 Oct 19.

Sección de Cirugía Colorrectal, Departamento de Cirugía, Hospital del Mar, Barcelona, España; Grupo de Investigación en Cáncer Colorrectal, Instituto de Investigación Médica Hospital del Mar (IMIM), Barcelona, España.

Introduction: Diverting stomata are recommended in patients with low anterior resection and risk factors in order to reduce the severity of anastomotic leaks. Usually, a radiology study is performed prior to the closure of the stoma to detect subclinical leaks. The aim of the present study is to assess the clinical utility of the radiology study. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0009739X183022
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http://dx.doi.org/10.1016/j.ciresp.2018.08.005DOI Listing
March 2019
10 Reads

Outcome of patients with acute pancreatitis requiring intensive care admission: A retrospective study from a tertiary care center of Pakistan.

Pak J Med Sci 2018 Sep-Oct;34(5):1082-1087

Muhammad Sohaib, Department of Anaesthesiology, The Aga Khan University, Karachi, Pakistan.

Background And Objective: Acute pancreatitis (AP) is an inflammatory disease. Patients presenting with severe disease may require intensive care unit (ICU) admission. Factors predicting mortality and morbidity need to be identified for improving outcome. Read More

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http://pjms.com.pk/index.php/pjms/article/view/15575
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http://dx.doi.org/10.12669/pjms.345.15575DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191773PMC
October 2018
13 Reads

Hidden diagnosis behind viral infection: the danger of anchoring bias.

BMJ Case Rep 2018 Oct 21;2018. Epub 2018 Oct 21.

Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan.

Anchoring bias is one of the most common diagnostic biases that may lead to closed-minded thinking and could result in unnecessary tests, inappropriate patient management and even misdiagnosis. A 4-year-old boy was brought to the emergency department because of shaking chills. On the basis of bilateral swollen preauricular areas, high level of serum amylase and the prevalence of mumps, he initially received a diagnosis of mumps in spite of the shaking chills. Read More

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http://dx.doi.org/10.1136/bcr-2018-226613DOI Listing
October 2018
7 Reads

Abdominal organ perfusion and inflammation in experimental sepsis: a magnetic resonance imaging study.

Am J Physiol Gastrointest Liver Physiol 2019 Jan 18;316(1):G187-G196. Epub 2018 Oct 18.

Hedenstierna Laboratoriet, Department of Surgical Science, Uppsala University , Uppsala , Sweden.

Diffusion-weighted magnetic resonance imaging (DW-MRI) uses water as contrast and enables the study of perfusion in many organs simultaneously in situ. We used DW-MRI in a hypodynamic sepsis model, comparing abdominal organ perfusion with global hemodynamic measurements and inflammation. Sixteen anesthetized piglets were randomized into 3 groups: 2 intervention (sepsis) groups: HighMAP (mean arterial pressure, MAP > 65 mmHg) and LowMAP (MAP between 50 and 60 mmHg), and a Healthy Control group (HC). Read More

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http://dx.doi.org/10.1152/ajpgi.00151.2018DOI Listing
January 2019
6 Reads

Complicated intra-abdominal infections: a prospective validation study of the WSES Sepsis Severity Score.

Singapore Med J 2018 Oct 10. Epub 2018 Oct 10.

Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.

Introduction: The World Society of Emergency Surgery (WSES) has recently developed and validated a sepsis severity score for complicated intra-abdominal infections (cIAIs). We aimed to prospectively study the validity of this score in our local setting and compare it with global findings.

Methods: In a prospective study of 100 consecutive adult patients with cIAIs treated at Al-Ain Hospital, United Arab Emirates, from October 2014 to January 2016, we studied the demography of patients, disease, risk factors, WSES Sepsis Severity Score, management, hospital stay and mortality. Read More

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http://www.smj.org.sg/sites/default/files/OA-2017-111-epub.p
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http://dx.doi.org/10.11622/smedj.2018120DOI Listing
October 2018
6 Reads

Intra-abdominal Sepsis After Ileocolic Resection in Crohn's Disease: The Role of Combination Immunosuppression.

Dis Colon Rectum 2018 12;61(12):1393-1402

Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota.

Background: Intra-abdominal sepsis complicates <10% of ileocolic resections for Crohn's disease, but the impact of combination immunosuppression and repeat resection on its development remains unknown.

Objective: The purpose of this study was to determine risk factors for intra-abdominal sepsis after ileocolic resection, specifically examining the role of combination immunosuppression and repeat intestinal resection.

Design: This was a retrospective review of patient records from 2007 to 2017. Read More

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http://dx.doi.org/10.1097/DCR.0000000000001153DOI Listing
December 2018
9 Reads

Microbe Isolation from Blood, Central Venous Catheters, and Fluid Collections after Liver Resections.

Surg Infect (Larchmt) 2019 Jan 9;20(1):49-54. Epub 2018 Oct 9.

Second Department of Propaedeutic Surgery, "Laiko" General Hospital, National and Kapodistrian University of Athens , Medical School, Athens, Greece .

Background: Our goal was to evaluate the microbe species responsible for bacteremia or infections related to central venous catheter (CVC) or fluid collections after liver resection.

Patients And Methods: Data from 112 patients (68 males, 44 females) who underwent liver resection over a period of 63 months were reviewed. Patient and tumor characteristics, intra-operative and post-operative data, and the results from cultures of peripheral blood, CVC tips and drained intra-abdominal or intra-throracic fluid collections were collected. Read More

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http://dx.doi.org/10.1089/sur.2018.122DOI Listing
January 2019
3 Reads