Laparoscopic extraction of gastric self-expandable metallic stent after migration in ileum: A case report.

Revisional surgery in bariatric patients can sometimes lead to life-threatening complications that need a fast diagnosis and treatment as well as a multidisciplinary approach. If left undiagnosed or untreated, this may lead to sepsis, multiple organ failure, and death. In this case report, we describe the management of a gastric perforation which occurred after conversion of a gastric banding to a sleeve gastrectomy.

Clinical guidelines for the practice of peripheral nerve blocks in the adult.

These guidelines, made by BARA, are, like the "Safety First Guidelines" of the SARB, clinical recomendations for a good and safe practice when performing peripheral nerve blocks (PNB). These recommendations were made according to the most recent literature and experts opinion and are therefore prone to changes due to evolution of literature. The guidelines deal with "Informed Consent", preoperative visit, monitoring, equipment and the PNB procedure itself regardless of using ultrasound or neurostimultion or both. Advise is given when combining a PNB with general anesthesia and when a catheter technique is used.

Fatal outcome after polytrauma: multiple organ failure or cerebral damage?

To assess the relative importance of multiple organ failure (MOF) and cerebral damage on the mortality rate following trauma we analyzed retrospectively the records from 99 polytrauma patients admitted to a multidisciplinary European intensive care unit in a 2 year period. In all, 93% of the trauma was non-penetrating and 73% was the result of road accidents. 28 patients died giving an overall mortality of 28.3%. The cause of death was cerebral lesions in 19 patients, hemorrhagic shock in eight and multiple organ failure in one patient who had an injury severity score (ISS) of 13. Most deaths (78%) occurred within 24 h of admission, 15 of these were due to extensive cerebral lesions and seven due to hemorrhagic shock. A total of six deaths occurred after 24 h, four due to extensive cerebral lesions, one due to hemorrhagic shock and one due to multiple organ failure. In our experience, cerebral damage was a more common cause of death than MOF following multiple non-penetrating trauma.