Gastrointestinal complications after cardiac surgery / 中国胸心血管外科临床杂志

@#Gastrointestinal complications after cardiac surgery are rare, but they are associated with significant morbidity and mortality. The mechanisms of gastrointestinal complications after cardiac surgery may be unique, as the abdominal cavity is not involved. This review summarizes the current evidence of the pathophysiology, clinical manifestations, risk factors, and management of gastrointestinal complications after cardiac surgery, aiming to improve the recognition of gastrointestinal complications after cardiac surgery.

Research progress on gastrointestinal complications after lung transplantation / 器官移植

Due to the influence of immunosuppression, nerve injury and other comprehensive factors, the overall incidence of gastrointestinal complications after lung transplantation is relatively high, which can cause drug absorption disorder and chronic rejection. In recent years, more and more studies have been conducted on these complications. However, due to the great difference of the incidence of gastrointestinal complications among lung transplantation centers, clinicians lack of understanding of these. In this article, the general status, common types and risk factors of gastrointestinal complications after lung transplantation were reviewed, aiming to provide reference for comprehensive management of gastrointestinal complications after lung transplantation.

Effects of auricular point sticking on plasma motilin in patients after gynecological laparoscopic operation under general anesthesia / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy of auricular point sticking on prevention and treatment of gastrointestinal complications after gynecological laparoscopic operation of general anesthesia, and to explore whether it is achieved by regulating the secretion of plasma motilin (MTL).</p><p><b>METHODS</b>Sixty patients who received selective gynecological laparoscopy under general anesthesia were randomly assigned into an observation group and a control group, 30 patients in each one. The patients in the observation group were treated with auricular point sticking at each morning and night, 30 min before anesthesia, revival after surgery and 24 h after surgery. The adhesive fabric with vaccaria seeds was pressed at shenmen (TF), wei (CO), benmen (CO), jiaogan (AH) and pizhixia (AT) for 3 to 5 min until the sensation of sourness, distension and numb appeared. The treatment was given for one week. The patients in the control group were treated only with similar adhesive fabric at auricular points at identical time points; each auricular point was pressed for 3 to 5 min. The anus exhaust time, defecating time and borborygmus were recorded; the level of plasma MTL was tested 30 min before anesthesia, 24 h after o-peration and 48 h after operation; the occurrence of nausea and vomiting from the end of operation to the end of treatment were also recorded.</p><p><b>RESULTS</b>Compared with the control group, the occurrence of nausea after operation was reduced in the observation group (<0.05), and the anus exhaust time and defecating time were shortened (both<0.05), and the recovery of borborygmus was improved (<0.05). The levels of MTL 24 h and 48 h after surgery were higher than those before operation in the two groups (all<0.05); The levels of MTL 24 h and 48 h after surgery in the observation group were significantly lower than those in the control group (both<0.05).</p><p><b>CONCLUSIONS</b>The assist of auricular point sticking could reduce the occurrence of nausea-vomiting and accelerate the recovery of gastrointestinal function in gynecological laparoscopic operation under general anesthesia, which is likely to be related with the inhibition on excess secretion of MTL.</p>

A Case of Kawasaki Disease with Colonic Edema

Kawasaki disease (KD) is recognized as a systemic vasculitis affecting multi-organ with inflammatory changes. The commonest and most serious complication of KD is coronary artery aneurysm, but KD may cause other organic complications beside cardiac problems. Gastrointestinal tract also present complications of KD in which, for example, hepatic dysfunction, pancreatitis, intussusception, colonic obstruction, intestinal pseudo-obstruction, and bowel edema are included. Among them, colonal wall edema is left unknown in the incidence, and it has been reported even if rare. In this report, we describe a case of KD with colonal wall edema, occurred in 5-yr-old boy who complained of severe abdominal pain and vomiting.

Small Bowel Complication Due to Magnetic Foreign Body Ingestion in Childhood

Accidental ingestion of foreign body is a common problems in pediatric emergencies. The majority of such cases occur in children between 6 months and 3 years of age. 80% of ingested foreign bodies which reach the stomach will pass uneventfully through the gastrointestinal tract, however the remainder may cause obstruction, perforation or hemorrhage. When several magnets are ingested, they can be attracted to each other through the intestinal wall, causing necrosis and intestinal perforation or fistula, so they should be removed while they are still in the stomach. The authors experienced 2 cases of unusual small bowel complication caused by the ingestion of magnets. The first case was a 10-month-old male with ileal perforation due to 2 ingested magnetic beads, and the second case was a 22-month-old male with ileo-ileal fistula due to 7 ingested magnetic beads.

Gastrointestinal Complications after Cardiac Transplantation / 대한이식학회지

Serious complications involving the alimentary tract are commonly reported following cardiac transplantation and may be associated with significant morbidity and mortality. Between April 1994 and April 1996, 17 patients underwent orthotopic cardiac transplantation at the Buchon Sejong General Hospital. Recipients comprised 15 males and 2 females with a mean age of 33-years old. Basic immunosuppressive therapy was accomplished with immuran and cyclosporine and prednisolone. Gastrointestinal complications developed in 10 patients(58.8%), including gastritis[n=4(23.5%)], nonspecific enteritis[n=3(17.6%)], cholecystitis[n=1(5.8%)], perianal abscess[n=1(5.8%)] and panperitonitis due to mesenteric infarction[n=1(5.8%)]. Among them three patients required surgical procedures and one is dead due to sepsis and multiple organic failure(surgical mortality:33.3%). Gastrointestinal complications in cardiac transplantation are frequent cause of postoperative morbidity and mostly step benign courses, they should be detected as soon as possible and be managed with aggressive intervention. Early, aggressive surgical intervention may reduce subsequent mortality.