ABSTRACT
OBJECTIVES: Perforated jejunal diverticulitis (PJD) is rare, but it has high mortality rates. The role of nonsurgical management is debated. The aim of this study is to assess the outcomes of medical and surgical management of PJD. PATIENTS AND METHODS: A single-centre study on a series of emergency patients diagnosed with PJD between 2010 and 2016 was conducted. RESULTS: Eleven patients with PJD were treated (seven women). Nine out of 11 were diagnosed by a computed tomography scan, and two were diagnosed at laparotomy. The initial approach was medical treatment in five patients, based on clinical and imaging findings. Four (80%) of these five patients were discharged without the need for surgical intervention. The median hospital stay was 7.5 days. Seven patients required surgery overall with a median length of hospital stay of 10.8 days. Surgical procedures consisted of segmental bowel resection and primary anastomosis in six patients and simple closure in one. There was no perioperative deaths. One patient required percutaneous drainage because of anastomotic leak, and one required reoperation owing to evisceration. DISCUSSION: Selected patients with PJD can be successfully managed with conservative approach, based on clinical and computed tomography findings.
Subject(s)
Conservative Treatment , Digestive System Surgical Procedures , Diverticulitis/therapy , Intestinal Perforation/therapy , Jejunal Diseases/therapy , Aged , Conservative Treatment/adverse effects , Digestive System Surgical Procedures/adverse effects , Diverticulitis/diagnostic imaging , Diverticulitis/surgery , Drainage , Emergencies , Female , Humans , Intestinal Perforation/diagnostic imaging , Intestinal Perforation/surgery , Jejunal Diseases/diagnostic imaging , Jejunal Diseases/surgery , Length of Stay , Male , Postoperative Complications/therapy , Reoperation , Retrospective Studies , Risk Factors , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Dermatofibrosarcoma/surgery , Dermatofibrosarcoma , Mammaplasty/methods , Mammaplasty , Neoadjuvant Therapy/methods , Imatinib Mesylate/therapeutic use , Dermatofibrosarcoma/mortality , Dermatofibrosarcoma/pathology , Mammography , Immunohistochemistry/methodsABSTRACT
BACKGROUND: Rives-Stoppa repair is widely accepted technique in large midline IH, and appears to be advantageous compared to other surgical techniques concerning complications and recurrence rates. The aim of this case series study was to analyze 1-year outcomes in patients with IH treated with Progrip self-gripping mesh compared to polypropylene (PPL) mesh fixed with sutures during the Rives-Stoppa technique. METHODS: Between June 2014 and June 2015, we performed a prospective comparative non-randomized (case series) analysis between 25 patients with IH using retromuscular Progrip self-gripping mesh and 25 patients with retromuscular PPL mesh fixed with sutures, under Rives-Stoppa repair. All intraoperative and perioperative morbidities were reported with particular attention to wound infection, seroma or hematoma formation, duration of hospital stay, presence of abdominal wall pain (VAS) and recurrence during long-term follow-up. RESULTS: Mean operative time in Progrip group was shorter than Non-Progrip group (101±29.5 versus 121±39.8min). In Progrip group, the only postoperative complication was seroma in two patients; however, in Non-Progrip group, we reported seroma in three patients, and hematoma in 4 patients (p=0.03). The median hospital stay was shorter in Progrip group (5.8±2.2days versus 6.6±2.9days). Mean VAS score in the first 48h was higher in Non-Progrip group than Progrip group (4.9±2.1 versus 8.1±2)(p=0.01). The median follow-up was 13 months (range 12-20 months) and none of the 50 patients had a hernia recurrence. CONCLUSIONS: In Rives-Stoppa repair, retromuscular Progrip mesh causes less postoperative pain in the first 48h and lower rate of hematoma than PPL mesh fixed with sutures in the short term follow-up.
ABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Pancreatitis, Acute Necrotizing/complications , Retropneumoperitoneum/etiology , Tomography, X-Ray ComputedSubject(s)
Breast Diseases/diagnosis , Diabetes Mellitus, Type 1/complications , Adult , Biopsy, Large-Core Needle , Breast Diseases/etiology , Breast Diseases/pathology , Breast Diseases/therapy , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Mammography , Middle Aged , Ultrasonography, MammaryABSTRACT
No disponible
