Fluorescent test accurately predicts leak of ischemic colon anastomosis in rats

Abstract Purpose: To investigate if fluorescein fluorescent test can predict dehiscence in a model of ischemic colonic anastomosis in rats. Methods: This experimental controlled trial randomly assigned 55 rats to four groups. Anastomoses were performed in non-ischemic colon segments (control group) and in ischemic colon segments measuring 1, 2 or 3 cm long (groups 1, 2 and 3, respectively). Fluorescein was injected and the tissues were examined under ultraviolet light. Seven days later, a second-look surgery was performed to check for the presence or absence of anastomosis dehiscence. Results: Twenty-four rats presented anastomotic dehiscence during the second-look surgery. Reticular and nonfluorescent patterns were significantly associated with the occurrence of anastomotic dehiscence. Fluorescein fluorescence had a sensitivity of 95.8%, specificity of 89.2%, positive predictive value of 88.4%, negative predictive value of 96.2%, and accuracy of 92.3% to predict anastomotic dehiscence. Conclusion: Fluorescein fluorescent test can accurately predict leak in a model of ischemic colonic anastomosis in rats.

Blind pouch syndrome: case report and literature review

Blind pouch syndrome is the set of signs and symptoms caused by intestinal content stasis and consequent bacterial hyperproliferation in a segment excluded from the intestinal flow after surgical procedure. This paper reports the case of a 65-year-old male patient complaining of diffuse abdominal pain, poor oral intake, nausea, diarrhea, fever and chills. Surgical history included cecal resection five years before due to a tubulovillous adenoma. On physical examination, the abdomen was tender and distended, without signs of peritonitis. Complete blood cells count showed microcytic anemia. Computed tomography of the abdomen revealed ileocolonic anastomosis (ascending) with blind loop presenting signs of inflammatory process. Exploratory laparotomy was indicated, in which the resection of the blind loop was performed. After gradual improvement of the symptoms, the patient was discharged in12th post-operative day...