Successful percutaneous drainage with iodine irrigation for pancreatic fistulas and abscesses after necrotizing pancreatitis

To report an uncommon method of managing pancreatic fistulas and retroperitoneal abscess. A 50-year-old man was admitted with fever, abdominal pain, periumbilical fistula and pus in stool. Five months before admission, he underwent urgent necrosectomy [7 days after onset of pain] and subsequently two more surgeries for necrotizing pancreatitis. Ultrasound revealed fluid collection in the retropancreatic space. After evacuation of pus, contrast medium instilled through a catheter showed a retroperitoneal abscess cavity, retroperitoneal-periumbilical and retroperitoneal-sigmoidal fistulas. After percutaneous drainage and iodine irrigation, the abscess collection and fistulas disappeared. In this case, percutaneous drainage was a successful option in the management of pancreatic fistulas and a retroperitoneal abscess

Survival of living-related kidney graft recipients in the era of modern immunosuppressive treatment

Currently, there is no consensus about immunosuppressive therapy following kidney transplantation. Acute rejection rates and allograft survival rates are the clinical outcomes traditionally used to compare the efficacy of various immunosuppressive regimens. Therefore, we conducted this study to evaluate whether patient survival rates improved in the era of modern immunosuppressive treatment during living-related kidney transplantation. Retrospective cohort study in a university-based tertiary internal medicine teaching hospital performed between 1999 and 2009 and patients followed up to 7 years. Survival rates were assessed in 38 patients receiving basiliximab and mycophenolate mofetil [regimen A] and 32 patients receiving antithymocyte globulin and azathioprine [regimen B]. The rest of the regimen [cyclosporine A and steroids] remained the same. A secondary end point was acute rejection episode. Seven-year survival rates were 100% and 72% [P=.001] and 7-year acute rejection-free survival rates were 82% and 53% [P=.03], in groups A and B, respectively. Long-term survival after living-related kidney transplantation has improved in the era of modern immunosuppressive treatment