Acute phlegmonous gastritis complicated by delayed perforation
58
Citation
21
Reference
10
Related Paper
Citation Trend
Abstract:
Here, we report on a case of acute phlegmonous gastritis (PG) complicated by delayed perforation.A 51-year-old woman presented with severe abdominal pain and septic shock symptoms.A computed tomography scan showed diffuse thickening of the gastric wall and distention with peritoneal fluid.Although we did not find definite evidence of free air on the computed tomography (CT) scan, the patient's clinical condition suggested diffuse peritonitis requiring surgical intervention.Exploratory laparotomy revealed a thickened gastric wall with suppurative intraperitoneal fluid in which Streptococcus pyogenes grew.There was no evidenceKeywords:
Esophagogastroduodenoscopy
Exploratory laparotomy
Perforation
Postoperative morbidity and mortality were studied in 72 patients who consecutively underwent total gastrectomy for primary gastric malignancy. Patients aged greater than or equal to 70 years (n = 32) were compared with younger patients (n = 40). Two patients in both groups died postoperatively, making the surgical mortality 6.3% and 5%, respectively. Major surgical complications arose postoperatively in 12 cases. Conservative measures (balloon dilation of anastomotic stricture, protracted drainage, and puncture and drainage of intraabdominal abscess) sufficed in five cases, while reoperation was required in seven. One of these seven patients died. The remaining three deaths were due to myocardial infarction, cerebral vascular insult and exudative pericarditis, respectively. The median postoperative hospital stay was 14 days in the younger and 15 days in the older patient group. Approximately half of the patients in both groups were alive 2 years postoperatively. Total gastrectomy is a meaningful and reasonably safe operation for primary gastric malignancy also in elderly patients.
Cite
Citations (9)
Objective To investigate the diagnosis and the efficacy of surgical treatment of acute gastroduodenal ulcer perforation.Methods Sixty-three patients with acute gastroduodenal ulcer perforation admitted to and treated in our hospital from April 2008 to December 2011 were diagnosed retrospectively according to the clinical symptoms,abdominal puncture and X-ray examinations.Then the patients were divided into the laparoscopic group(experimental group) with 30 patients and the laparotomy group(control group) with 33 patients.The operation time,postoperative exhaust time,hospital stay,amount of intraoperative bleeding,incision infection and the number of cases of postoperative analgesics use were compared and analyzed retrospectively.Results The laparoscopic group was obviously lower than the laparotomy group in the postoperative exhaust time,hospital stay,amount of intraoperative bleeding,incision infection and the number of cases of postoperative analgesics use,with statistically significant differences(P0.01),but was obviously higher in the operation time,with statistically significant differences(P0.05).Conclusion For the repair of acute gastroduodenal ulcer perforation,laparoscopy has the advantages of small trauma,early recovery and short hospital stay compared to the laparotomy,thereby is an ideal solution for the treatment of acute gastroduodenal ulcer perforation.
Gastroduodenal ulcer
Perforation
Cite
Citations (0)
Perforated viscus is a fatal condition associated with a high mortality rate that necessitating immediate management. In gastric cancer, perforation is a relatively late rare presentation. In this study, we report a case of a 40-year-old male who presented with perforated gastric cancer. In the emergency department (ED), the provisional diagnosis was septic peritonitis and shock. However, upon exploratory laparotomy, pyloric tumor was detected metastasizing to the duodenum, liver, and porta hepatis.
Exploratory laparotomy
Perforation
Presentation (obstetrics)
Cite
Citations (1)
A 30-year-old male suffered from acute abdomen following duodenal biopsy taken at esophagogastroduodenoscopy (EGD). Exploratory laparotomy showed a large retroperitoneal hematoma arising from the second part of the duodenum that was then treated conservatively. To the authors' knowledge, this is the first case of extensive retroperitoneal hematoma following EGD. The hemorrhage is speculated to have been caused by the tearing of one of the pancreaticoduodenal arteries or one of their branches during the duodenal biopsy.
Esophagogastroduodenoscopy
Exploratory laparotomy
Acute abdomen
Retroperitoneal space
Cite
Citations (5)
Internal hernias are rarely diagnosed. Most of the times they are found at laparotomy when complications and their symptoms (for instance palpable tumour, abdominal pain, vomiting and ileus) require surgical treatment. We present a case of an eleven-year-old boy who was admitted to our hospital because of acute abdominal pain. Appendectomy brought only temporary relief of pain. Subsequent laparotomy yielded the diagnosis of left-sided paraduodenal hernia.
Ileus
Acute abdomen
Internal hernia
Cite
Citations (2)
Background: Exploratory laparotomy is a major surgical procedure. Midline laparotomy is the most common technique of opening the abdomen as it is simple, provides adequate exposure to all four quadrants, and affords quick exposure with minimal blood loss. Laparotomy wounds have been closed in various ways in terms of continuous versus interrupted closure, single layer versus mass closure, and absorbable versus non-absorbable sutures. Aims and Objectives: The aim of the study was to find out the technique of rectus sheath closure in patients undergoing exploratory laparotomy that can reduce the burden of complications in post-operative period. Materials and Methods: It is a hospital-based prospective randomized observational study which was conducted in a rural-based tertiary care hospital and medical college with a time frame of about 1½ years. A total number of 74 patients of adult age group (21–70 yrs) admitted in general surgery ward of Bankura Sammilani Medical College and Hospital, undergoing exploratory laparotomy. Results: Thirty-seven (50%) patients of midline laparotomy were closed in continuous technique. Rest 37 (50%) patients were closed in interrupted technique. The hospital stay was similar in both groups. There was no significant difference in incidence of wound infection (P=0.4687). Wound dehiscence and requirement of burst abdomen repair was significantly higher in continuous suture group as compared to interrupted suture group, but mean closure time (P<0.0001) and mean suture length (P=0.0436) were significantly higher in interrupted suture group. Conclusion: The major complication of emergency laparotomy is wound dehiscence which leads to increased morbidity and subsequent requirement of re-operation of burst abdomen and hospital cost. In our study, we found that interrupted suturing method of abdominal closure is better in respect to major post-operative complications though it requires more suture length and time.
Exploratory laparotomy
Wound dehiscence
Barbed suture
Cite
Citations (2)
Exploratory laparotomy
Cite
Citations (56)
Many of the abdominal foreign bodies are due to accidental ingestion. Our objective in this case report is to emphasize the importance of the enquiry about the foreign body in the differential diagnosis of acute abdominal pain. According to our knowledge, this is the first report of bowel perforation caused by paper ingestion. A 14-year-old boy with abdominal pain underwent exploratory laparotomy and was found to have abdominal pus and ileal perforation. A crumpled paper was found at the site of perforation. Postoperative enquiry revealed that the patient had ingested 10 crumpled papers. We highlight that recording the history is an important aspect in the management of patients with acute abdominal pain and that foreign bodies should be included in its differential diagnosis.
Exploratory laparotomy
Perforation
Acute abdominal pain
Accidental
Cite
Citations (9)
Objective To investigate the time and clinical effects of transfer surgery for patients with upper gastrointestinal perforation who had received unsuccessful conservative treatment.Methods Clinical information of 11 patients with upper gastrointestinal perforation who suffered from aggravating abdominal pain and distension,demonstrated hyperpyrexia or shock and received transfer surgery 12 hours after receiving conservative treatment were analyzed retrospectively.Nine patients received perforation repair,one patient received routine palliative gastric cancer resection(subtotal gastrectomy),and one received radical distal gastric cancer resection.Results Ten patients were cured by transfer surgery and one died.Conclusion For patients with upper gastrointestinal perforation,if the clinical effects of early conservative treatment are poor and the peritonitis aggravates,the surgical treatment should be applied timely.
Perforation
Conservative Treatment
Cite
Citations (0)
A 71-year-old man presented to our hospital with generalised abdominal pain. Initial laboratory investigations were normal and an abdominal CT scan was inconclusive. The following day, persisting pain, generalised tenderness and haemodynamic instability prompted exploratory laparotomy. At laparotomy, two perforations of the proximal jejunum were identified caused by two 3 cm pieces of wood. The pieces of wood were retrieved and the perforations repaired primarily. The postoperative period was complicated by acute confusion but the patient went on to make a full recovery. On direct questioning, the patient was unable to explain the presence of wood within his gastrointestinal tract. One hypothesis was that he may have ingested this material during a period of acute confusion following an elective abdominal aortic aneurysm repair 8 years previously.
Exploratory laparotomy
Confusion
Jejunum
Cite
Citations (1)