Surgical Wound Dehiscence
Capillary Leak Syndrome
Cerebrospinal Fluid Rhinorrhea
A safe and reproducible anastomotic technique for minimally invasive Ivor Lewis oesophagectomy: the circular-stapled anastomosis with the trans-oral anvil. (1/105)(+info)
Effect of preoperative intraperitoneal injection of Sapylin in advanced gastric cancer. (2/105)BACKGROUND AND OBJECTIVE: Sapylin is one of the biological response modifiers. It has been used in the comprehensive treatment for advanced cancer, and its clinical efficacy has been proved. This study was to evaluate the effect of preoperative intraperitoneal injection of Sapylin in treatment of advanced gastric cancer. METHODS: Seventy-nine patients eligible for radical gastrectomy were randomly divided into the treatment group (Sapylin + mitomycin C, 40 patients) and the control group (mitomycin C alone, 39 patients). In the treatment group, 5 KE Sapylin was injected intraperitoneally 48 h before operation and 4 mg of mitomycin C was injected into peritoneal cavity before the closure of the peritoneum. In the control group, only 4 mg mitomycin C was injected into peritoneal cavity before the closure of the peritonium. RESULTS: There was no operative mortality or duodenal stump leakage in the two groups. Postoperative complications were anastomotic leakage (2.5%, 1/40) and incision rupture (2.5%, 1/40) in the treatment group, and incision rupture (2.6%, 1/39) in the control group, with no significant difference between the two groups (P > 0.05). The 3-year survival rate was significantly higher in the treatment group than in the control group (76.5% vs. 49.4%, P < 0.05). CONCLUSIONS: Preoperative intraperitoneal injection of Sapylin can raise the 3-year survival rate after radical gastrectomy , without increasing the incidence rate of operative complications. Preoperative intraperitoneal injection of Sapylin is therefore a valuable therapy for advanced gastric cancer in clinic. (+info)
Retrograde single stapling technique for laparoscopic ultralow anterior resection. (3/105)(+info)
Hybrid NOTES transgastric cholecystectomy with reliable gastric closure: an animal survival study. (4/105)(+info)
Recurrent abscess after primary successful endo-sponge treatment of anastomotic leakage following rectal surgery. (5/105)AIM: To assess long-term efficacy of initially successful endo-sponge assisted therapy. METHODS: Between 2006 and 2009, consecutive patients who had undergone primary successful endo-sponge treatment of anastomotic leakage following rectal cancer surgery were enrolled in the study. Patients were recruited from 6 surgical departments in Vienna. Clinical and oncologic outcomes were assessed through routine endoscopic and radiologic follow-up examination. RESULTS: Twenty patients (7 female, 13 male) were included. The indications for endo-sponge treatment were anastomotic leakage (n = 17) and insufficiency of a rectal stump after Hartmann's procedure (n = 3). All patients were primarily operated for rectal cancer. The overall mortality rate was 25%. The median follow-up duration was 17 mo (range 1.5-29.8 mo). Five patients (25%) developed a recurrent abscess. Median time between last day of endo-sponge therapy and occurrence of recurrent abscess was 255 d (range 21-733 d). One of these patients was treated by computed tomography-guided drainage and in 3 patients Hartmann's procedure had to be performed. Two patients (10%) developed a local tumor recurrence and subsequently died. CONCLUSION: Despite successful primary outcome, patients who receive endo-sponge therapy should be closely monitored in the first 2 years, since recurrence might occur. (+info)
Laparoscopic low anterior resection for rectal carcinoma: complications and management in 132 consecutive patients. (6/105)AIM: To analyze the clinical manifestations and risk factors of complications in laparoscopic low anterior resection (LAR) for rectal cancer patients. METHODS: A series of 132 consecutive patients who received laparoscopic LAR for rectal cancer in our center were included. The etiology, diagnosis, treatment and prevention of rectal cancer were studied among the patients with surgery-related complications using both univariate and multivariate regression analysis. RESULTS: No conversion to open surgery was observed and 5 cases converted to hand-assisted laparoscopic operation. The overall morbidity rate was 20.5%. Complications occurred during the operation in 7 patients (5.3%), within 30 postoperative days in 24 patients (18.2%), and within 3 mo in 2 patients (1.5%). The most significant complications were anastomotic leakage (9.1%) and anastomotic hemorrhage (5.3%). Size and location of tumor, pathological staging and preoperative nutrition were significant factors associated with LAR complications, while gender, age and pathological type showed no relevance. Binary logistics regression showed that the size and location of tumor, and pathological staging were independent factors of laparoscopic LAR. All the complications were treated during their onset of clinical manifestations by interventional or conservative therapy. CONCLUSION: Anastomotic leakage is a major complication in laparoscopic LAR. The complications may be associated with tumor size and site, and pathological stage. Interventional therapies are of value in the management of laparoscopic LAR complications. (+info)
The use of a compression device as an alternative to hand-sewn and stapled colorectal anastomoses: is three a crowd? (7/105)(+info)
The C-seal: a biofragmentable drain protecting the stapled colorectal anastomosis from leakage. (8/105)(+info)
1. Poor surgical technique
2. Inadequate mobilization of the bowel segments
3. Insufficient blood supply to the anastomosis
4. Presence of adhesions or scar tissue in the abdomen
6. Leakage of the sutures or staples
7. Use of suboptimal surgical materials
8. Delayed recovery from anesthesia
1. Abdominal pain and tenderness
3. Nausea and vomiting
4. Diarrhea or constipation
5. Peritonitis (inflammation of the lining of the abdominal cavity)
6. Sepsis (systemic infection)
7. Abscess formation
1. Physical examination and medical history
2. Imaging studies such as X-rays, CT scans, or MRI scans
3. Endoscopy or laparoscopy to visualize the anastomosis
4. Blood tests to check for signs of infection or inflammation
5. Surgical exploration and inspection of the anastomosis
1. Conservative management with antibiotics, fluid replacement, and bowel rest
2. Surgical intervention to repair the leak, which may involve opening the abdomen and revising the anastomosis
3. Use of surgical drainage devices to remove any abscess or infected fluid
4. Management of underlying infections or sepsis
5. Supportive care to maintain vital organ function and prevent complications.
1. Proper surgical technique and meticulous dissection during the initial surgery
2. Use of appropriate sutures and staples for anastomosis
3. Adequate hemostasis and control of bleeding
4. Proper postoperative care, including close monitoring and early detection of any complications
5. Patient education on signs of infection and the need for prompt medical attention if they experience any symptoms.
1. Gastroesophageal reflux disease (GERD): A condition in which stomach acid flows back up into the esophagus, causing symptoms such as heartburn and difficulty swallowing.
2. Esophagitis: Inflammation of the esophagus, often caused by GERD or infection.
3. Barrett's esophagus: A condition in which the cells lining the esophagus undergo abnormal changes, which can increase the risk of developing esophageal cancer.
4. Esophageal rings and webs: Abnormal bands of tissue that can form in the esophagus and cause difficulty swallowing or chest pain.
5. Achalasia: A condition in which the muscles in the lower esophagus do not function properly, making it difficult to swallow.
6. Esophageal cancer: Cancer that develops in the esophagus, often as a result of chronic inflammation or Barrett's esophagus.
7. Esophageal stricture: A narrowing of the esophagus that can cause difficulty swallowing.
8. Esophageal motility disorders: Disorders that affect the muscles in the esophagus and cause difficulty swallowing or regurgitation of food.
9. Esophageal spasms: Involuntary contractions of the muscles in the esophagus, which can cause difficulty swallowing or chest pain.
Esophageal diseases can be diagnosed through a variety of tests, including endoscopy, barium swallow, and CT scan. Treatment options vary depending on the specific disease and can include medications, surgery, or lifestyle changes such as dietary modifications and weight loss.
Surgical wound dehiscence is a condition where the incision or wound made during a surgical procedure fails to heal properly and starts to separate, leading to an open wound. This complication can occur due to various factors, such as poor wound care, infection, or excessive tension on the wound edges.
Types of Surgical Wound Dehiscence
There are several types of surgical wound dehiscence, including:
1. Superficial dehiscence: This type of dehiscence occurs when the skin over the incision starts to separate but does not extend into the deeper tissue layers.
2. Deep dehiscence: This type of dehiscence occurs when the incision starts to separate into the deeper tissue layers, such as muscles or organs.
3. Full-thickness dehiscence: This type of dehiscence occurs when the entire thickness of the skin and underlying tissues separates along the incision line.
Causes of Surgical Wound Dehiscence
Surgical wound dehiscence can occur due to a variety of factors, including:
1. Poor wound care: Failure to properly clean and dress the wound can lead to infection and delay healing.
2. Infection: Bacterial or fungal infections can cause the wound edges to separate.
3. Excessive tension on the wound edges: This can occur due to improper closure techniques or excessive tightening of sutures or staples.
4. Poor surgical technique: Improper surgical techniques can lead to inadequate tissue approximation and delayed healing.
5. Patient factors: Certain medical conditions, such as diabetes or poor circulation, can impair the body's ability to heal wounds.
Symptoms of Surgical Wound Dehiscence
The symptoms of surgical wound dehiscence may include:
1. Redness and swelling around the incision site
2. Increased pain or discomfort at the incision site
3. Discharge or fluid leaking from the incision site
4. Bad smell or foul odor from the incision site
5. Increased heart rate or fever
6. Reduced mobility or stiffness in the affected area
Treatment of Surgical Wound Dehiscence
The treatment of surgical wound dehiscence depends on the severity and underlying cause of the condition. Treatment options may include:
1. Antibiotics: To treat any underlying infections.
2. Dressing changes: To promote healing and prevent infection.
3. Debridement: Removal of dead tissue or debris from the wound site to promote healing.
4. Surgical revision: In some cases, the wound may need to be reclosed or revisited to correct any defects in the initial closure.
5. Hyperbaric oxygen therapy: To promote wound healing and reduce the risk of infection.
6. Surgical mesh: To reinforce the wound edges and prevent further separation.
7. Skin grafting: To cover the exposed tissue and promote healing.
Prevention of Surgical Wound Dehiscence
Preventing surgical wound dehiscence is crucial to ensure a successful outcome. Here are some measures that can be taken to prevent this condition:
1. Proper wound closure: The incision should be closed carefully and securely to prevent any gaping or separation.
2. Appropriate dressing: The wound should be covered with an appropriate dressing to promote healing and prevent infection.
3. Good surgical technique: The surgeon should use proper surgical techniques to minimize tissue trauma and promote healing.
4. Proper postoperative care: Patients should receive proper postoperative care, including monitoring of vital signs and wound status.
5. Early recognition and treatment: Any signs of dehiscence should be recognized early and treated promptly to prevent further complications.
Surgical wound dehiscence is a serious complication that can occur after surgery, resulting in unstable or gaping wounds. Prompt recognition and treatment are essential to prevent further complications and promote healing. Proper wound closure, appropriate dressing, good surgical technique, proper postoperative care, and early recognition and treatment can help prevent surgical wound dehiscence. By taking these measures, patients can achieve a successful outcome and avoid potential complications.
Esophageal atresia can be classified into several types based on the location and severity of the defect:
1. Type A: The most common type, where there is a complete absence of the esophagus.
2. Type B: There is a narrowing or gap in the mid-esophagus.
3. Type C: The lower esophagus is narrow or absent.
4. Type D: There is a ring-like structure at the end of the esophagus that blocks the passage of food.
Esophageal atresia can be associated with other congenital abnormalities, such as tracheoesophageal fistula (TEF), which is a connection between the trachea and esophagus. This association increases the risk of respiratory complications.
The symptoms of esophageal atresia can vary depending on the severity of the defect, but may include:
1. Difficulty swallowing (dysphagia)
2. Regurgitation of food
3. Coughing or gagging during feeding
4. Chest retractions (inward movement of the chest wall)
5. Cyanosis (blue discoloration of the skin)
6. Respiratory distress
7. Poor weight gain or growth
Esophageal atresia is diagnosed through a series of tests, including:
1. Chest X-ray: To identify any abnormalities in the esophagus or trachea.
2. Endoscopy: A flexible tube with a camera and light on the end is inserted through the mouth to visualize the esophagus and identify any narrowing or gaps.
3. Imaging tests: Such as CT scans or MRI to get a detailed view of the esophageal atresia and any related complications.
4. Biopsy: A small sample of tissue may be taken from the esophagus to rule out other conditions.
Treatment for esophageal atresia usually involves a combination of surgical and medical interventions. The goals of treatment are to repair the defect, restore normal swallowing and breathing, and prevent complications. Treatment options may include:
1. Surgery: To repair the atresia and restore continuity to the esophagus. This may involve an open surgical procedure or a minimally invasive procedure using endoscopy.
2. Tracheoesophageal puncture (TEP): A small hole is made in the trachea and esophagus to allow for passage of food and air.
3. Gastric tube placement: A tube may be placed through the nose and into the stomach to help with feeding until swallowing improves.
4. Medications: To manage symptoms such as reflux, aspiration, or respiratory infections.
5. Nutritional support: To ensure adequate nutrition and weight gain until swallowing improves. This may involve tube feeding or dietary supplements.
6. Respiratory therapy: To help improve breathing and prevent respiratory infections.
7. Follow-up care: Regular follow-up appointments with a pediatrician, gastroenterologist, and other specialists to monitor the child's progress and address any complications that may arise.
The long-term outlook for children with esophageal atresia varies depending on the severity of the condition and the effectiveness of treatment. With prompt and appropriate treatment, many children with esophageal atresia can lead active, healthy lives. However, some may experience ongoing respiratory and gastrointestinal problems, and may require long-term medication and follow-up care. In rare cases, esophageal atresia may be associated with other congenital anomalies or genetic disorders, which can affect the child's overall prognosis.
1. Infection: Bacterial or viral infections can develop after surgery, potentially leading to sepsis or organ failure.
2. Adhesions: Scar tissue can form during the healing process, which can cause bowel obstruction, chronic pain, or other complications.
3. Wound complications: Incisional hernias, wound dehiscence (separation of the wound edges), and wound infections can occur.
4. Respiratory problems: Pneumonia, respiratory failure, and atelectasis (collapsed lung) can develop after surgery, particularly in older adults or those with pre-existing respiratory conditions.
5. Cardiovascular complications: Myocardial infarction (heart attack), cardiac arrhythmias, and cardiac failure can occur after surgery, especially in high-risk patients.
6. Renal (kidney) problems: Acute kidney injury or chronic kidney disease can develop postoperatively, particularly in patients with pre-existing renal impairment.
7. Neurological complications: Stroke, seizures, and neuropraxia (nerve damage) can occur after surgery, especially in patients with pre-existing neurological conditions.
8. Pulmonary embolism: Blood clots can form in the legs or lungs after surgery, potentially causing pulmonary embolism.
9. Anesthesia-related complications: Respiratory and cardiac complications can occur during anesthesia, including respiratory and cardiac arrest.
10. delayed healing: Wound healing may be delayed or impaired after surgery, particularly in patients with pre-existing medical conditions.
It is important for patients to be aware of these potential complications and to discuss any concerns with their surgeon and healthcare team before undergoing surgery.
Types of Esophageal Neoplasms:
1. Barrett's Esophagus: This is a precancerous condition that occurs when the cells lining the esophagus undergo abnormal changes, increasing the risk of developing esophageal cancer.
2. Adenocarcinoma: This is the most common type of esophageal cancer, accounting for approximately 70% of all cases. It originates in the glands that line the esophagus.
3. Squamous Cell Carcinoma: This type of cancer accounts for about 20% of all esophageal cancers and originates in the squamous cells that line the esophagus.
4. Other rare types: Other rare types of esophageal neoplasms include lymphomas, sarcomas, and carcinoid tumors.
Causes and Risk Factors:
1. Gastroesophageal reflux disease (GERD): Long-standing GERD can lead to the development of Barrett's esophagus, which is a precancerous condition that increases the risk of developing esophageal cancer.
2. Obesity: Excess body weight is associated with an increased risk of developing esophageal cancer.
3. Diet: A diet high in processed meats and low in fruits and vegetables may increase the risk of developing esophageal cancer.
4. Alcohol consumption: Heavy alcohol consumption is a known risk factor for esophageal cancer.
5. Smoking: Cigarette smoking is a major risk factor for esophageal cancer.
6. Family history: Having a family history of esophageal cancer or other cancers may increase an individual's risk.
7. Age: The risk of developing esophageal cancer increases with age, with most cases occurring in people over the age of 50.
8. Other medical conditions: Certain medical conditions, such as achalasia, may increase the risk of developing esophageal cancer.
Symptoms and Diagnosis:
1. Dysphagia (difficulty swallowing): This is the most common symptom of esophageal cancer, and can be caused by a narrowing or blockage of the esophagus due to the tumor.
2. Chest pain or discomfort: Pain in the chest or upper back can be a symptom of esophageal cancer.
3. Weight loss: Losing weight without trying can be a symptom of esophageal cancer.
4. Coughing or hoarseness: If the tumor is obstructing the airway, it can cause coughing or hoarseness.
5. Fatigue: Feeling tired or weak can be a symptom of esophageal cancer.
6. Diagnosis: A diagnosis of esophageal cancer is typically made through a combination of endoscopy, imaging tests (such as CT scans), and biopsies.
1. Surgery: Surgery is the primary treatment for esophageal cancer, and can involve removing the tumor and some surrounding tissue, or removing the entire esophagus and replacing it with a section of stomach or intestine.
2. Chemotherapy: Chemotherapy involves using drugs to kill cancer cells, and is often used in combination with surgery to treat esophageal cancer.
3. Radiation therapy: Radiation therapy uses high-energy X-rays to kill cancer cells, and can be used alone or in combination with surgery or chemotherapy.
4. Targeted therapy: Targeted therapy drugs are designed to target specific molecules that are involved in the growth and spread of cancer cells, and can be used in combination with other treatments.
Prognosis and Survival Rate:
1. The prognosis for esophageal cancer is generally poor, with a five-year survival rate of around 20%.
2. Factors that can improve the prognosis include early detection, small tumor size, and absence of spread to lymph nodes or other organs.
3. The overall survival rate for esophageal cancer has not improved much over the past few decades, but advances in treatment have led to a slight increase in survival time for some patients.
Lifestyle Changes and Prevention:
1. Avoiding tobacco and alcohol: Tobacco and alcohol are major risk factors for esophageal cancer, so avoiding them can help reduce the risk of developing the disease.
2. Maintaining a healthy diet: Eating a balanced diet that is high in fruits, vegetables, and whole grains can help protect against esophageal cancer.
3. Managing obesity: Obesity is a risk factor for esophageal cancer, so maintaining a healthy weight through diet and exercise can help reduce the risk of developing the disease.
4. Reducing exposure to pollutants: Exposure to certain chemicals and pollutants, such as pesticides and asbestos, has been linked to an increased risk of esophageal cancer. Avoiding these substances can help reduce the risk of developing the disease.
5. Getting regular screening: Regular screening for Barrett's esophagus, a precancerous condition that can develop in people with gastroesophageal reflux disease (GERD), can help detect and treat esophageal cancer early, when it is most treatable.
Current Research and Future Directions:
1. Targeted therapies: Researchers are working on developing targeted therapies that can specifically target the genetic mutations that drive the growth of esophageal cancer cells. These therapies may be more effective and have fewer side effects than traditional chemotherapy.
2. Immunotherapy: Immunotherapy, which uses the body's immune system to fight cancer, is being studied as a potential treatment for esophageal cancer. Researchers are working on developing vaccines and other immunotherapies that can help the body recognize and attack cancer cells.
3. Precision medicine: With the help of advanced genomics and precision medicine, researchers are working to identify specific genetic mutations that drive the growth of esophageal cancer in each patient. This information can be used to develop personalized treatment plans that are tailored to the individual patient's needs.
4. Early detection: Researchers are working on developing new methods for early detection of esophageal cancer, such as using machine learning algorithms to analyze medical images and detect signs of cancer at an early stage.
5. Lifestyle modifications: Studies have shown that lifestyle modifications, such as quitting smoking and maintaining a healthy diet, can help reduce the risk of developing esophageal cancer. Researchers are working on understanding the specific mechanisms by which these modifications can help prevent the disease.
In conclusion, esophageal cancer is a complex and aggressive disease that is often diagnosed at an advanced stage. However, with advances in technology, research, and treatment options, there is hope for improving outcomes for patients with this disease. By understanding the risk factors, early detection methods, and current treatments, as well as ongoing research and future directions, we can work towards a future where esophageal cancer is more manageable and less deadly.
1. Ulcerative colitis: This is a chronic condition that causes inflammation and ulcers in the colon. Symptoms can include abdominal pain, diarrhea, and rectal bleeding.
2. Crohn's disease: This is a chronic condition that affects the digestive tract, including the colon. Symptoms can include abdominal pain, diarrhea, fatigue, and weight loss.
3. Irritable bowel syndrome (IBS): This is a common condition characterized by recurring abdominal pain, bloating, and changes in bowel movements.
4. Diverticulitis: This is a condition where small pouches form in the colon and become inflamed. Symptoms can include fever, abdominal pain, and changes in bowel movements.
5. Colon cancer: This is a type of cancer that affects the colon. Symptoms can include blood in the stool, changes in bowel movements, and abdominal pain.
6. Inflammatory bowel disease (IBD): This is a group of chronic conditions that cause inflammation in the digestive tract, including the colon. Symptoms can include abdominal pain, diarrhea, fatigue, and weight loss.
7. Rectal cancer: This is a type of cancer that affects the rectum, which is the final portion of the colon. Symptoms can include blood in the stool, changes in bowel movements, and abdominal pain.
8. Anal fissures: These are small tears in the skin around the anus that can cause pain and bleeding.
9. Rectal prolapse: This is a condition where the rectum protrudes through the anus. Symptoms can include rectal bleeding, pain during bowel movements, and a feeling of fullness or pressure in the rectal area.
10. Hemorrhoids: These are swollen veins in the rectum or anus that can cause pain, itching, and bleeding.
It's important to note that some of these conditions can be caused by other factors as well, so if you're experiencing any of these symptoms, it's important to see a doctor for an accurate diagnosis and treatment.
The symptoms of esophageal stenosis may include difficulty swallowing (dysphagia), regurgitation of food, chest pain, and weight loss. If left untreated, esophageal stenosis can lead to malnutrition and dehydration, which can be life-threatening.
Esophageal stenosis is diagnosed through a series of tests such as endoscopy, barium swallow, or CT scan. Treatment options may include dilation, where a small balloon or other device is inserted into the esophagus to stretch and widen the narrowed area. In severe cases, surgery may be necessary to remove the blocked or narrowed segment of the esophagus.
Esophageal stenosis can be caused by various conditions such as:
1. GERD (gastroesophageal reflux disease): Frequent acid reflux can cause inflammation and scarring in the esophagus, leading to stenosis.
2. Eosinophilic esophagitis: An allergic reaction that causes inflammation and narrowing of the esophagus.
3. Esophageal rings or webs: Abnormal growths that can block the esophagus and cause stenosis.
4. Cancer: Tumors in the esophagus can cause stenosis by blocking the passageway.
5. Infections: Such as H. pylori or herpes simplex virus, can cause inflammation and scarring in the esophagus.
6. Trauma: A injury to the esophagus due to a car accident, fall, or other traumatic event.
1. Sigmoiditis: This is an inflammation of the sigmoid colon that can be caused by infection or inflammatory conditions such as ulcerative colitis or Crohn's disease. Symptoms include abdominal pain, diarrhea, and rectal bleeding.
2. Diverticulosis: This is a condition where small pouches form in the wall of the sigmoid colon. These pouches can become inflamed (diverticulitis) and cause symptoms such as abdominal pain, fever, and changes in bowel movements.
3. Ulcerative colitis: This is an inflammatory condition that affects the lining of the sigmoid colon and rectum. Symptoms include abdominal pain, diarrhea, and rectal bleeding.
4. Crohn's disease: This is a chronic inflammatory condition that can affect any part of the gastrointestinal tract, including the sigmoid colon. Symptoms include abdominal pain, diarrhea, fatigue, and weight loss.
5. Cancer: Colon cancer can occur in the sigmoid colon, and symptoms may include blood in the stool, changes in bowel movements, and abdominal pain.
6. Hirschsprung's disease: This is a congenital condition where the nerve cells that control the movement of food through the colon are missing or do not function properly. Symptoms include constipation, abdominal pain, and diarrhea.
7. Intestinal obstruction: This is a blockage that prevents food, fluids, and gas from passing through the intestine. Symptoms include abdominal pain, nausea, vomiting, and constipation.
8. Ischemic colitis: This is a condition where there is a reduction in blood flow to the colon, which can cause inflammation and symptoms such as abdominal pain, diarrhea, and rectal bleeding.
9. Ulcerative colitis: This is a chronic inflammatory condition that affects the colon and symptoms include abdominal pain, diarrhea, and rectal bleeding.
10. Diverticulosis: This is a condition where small pouches form in the wall of the colon, which can cause symptoms such as abdominal pain, constipation, and diarrhea.
It's important to note that some of these conditions may not have any symptoms at all, so it's important to seek medical attention if you experience any unusual changes in your bowel movements or abdominal pain. A healthcare professional can perform a physical examination and order diagnostic tests such as a colonoscopy or CT scan to determine the cause of your symptoms and recommend appropriate treatment.
Rectal neoplasms refer to abnormal growths or tumors that occur in the rectum, which is the lower part of the digestive system. These growths can be benign (non-cancerous) or malignant (cancerous).
Types of Rectal Neoplasms:
There are several types of rectal neoplasms, including:
1. Adenoma: A benign growth that is usually found in the colon and rectum. It is a common precursor to colorectal cancer.
2. Carcinoma: A malignant tumor that arises from the epithelial cells lining the rectum. It is the most common type of rectal cancer.
3. Rectal adenocarcinoma: A type of carcinoma that originates in the glandular cells lining the rectum.
4. Rectal squamous cell carcinoma: A type of carcinoma that originates in the squamous cells lining the rectum.
5. Rectal melanoma: A rare type of carcinoma that originates in the pigment-producing cells (melanocytes) of the rectum.
Causes and Risk Factors:
The exact causes of rectal neoplasms are not known, but several factors can increase the risk of developing these growths. These include:
1. Age: The risk of developing rectal neoplasms increases with age, with most cases occurring in people over the age of 50.
2. Family history: Having a family history of colorectal cancer or polyps can increase the risk of developing rectal neoplasms.
3. Inflammatory bowel disease: People with inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, are at higher risk of developing rectal neoplasms.
4. Diet: A diet high in fat and low in fiber may increase the risk of developing rectal neoplasms.
5. Lifestyle factors: Factors such as smoking, obesity, and lack of physical activity may also increase the risk of developing rectal neoplasms.
The symptoms of rectal neoplasms can vary depending on the type and location of the growth. Some common symptoms include:
1. Blood in the stool
2. Changes in bowel movements (such as diarrhea or constipation)
3. Abdominal pain or discomfort
4. Weakness and fatigue
5. Loss of appetite
To diagnose rectal neoplasms, a doctor may perform several tests, including:
1. Digital rectal exam (DRE): A doctor will insert a gloved finger into the rectum to feel for any abnormalities.
2. Colonoscopy: A flexible tube with a camera and light on the end is inserted through the anus and into the rectum to examine the inside of the rectum and colon for polyps or other abnormalities.
3. Imaging tests: Such as X-rays, CT scans, or MRI scans to visualize the growth and determine its location and size.
4. Biopsy: A sample of tissue is removed from the rectum and examined under a microscope for cancer cells.
The treatment of rectal neoplasms depends on the type, location, and stage of the growth. Some common treatments include:
1. Polypectomy: Removal of polyps through a colonoscopy or surgery.
2. Local excision: Surgical removal of the tumor and a small amount of surrounding tissue.
3. Radiation therapy: High-energy beams are used to kill cancer cells.
4. Chemotherapy: Drugs are used to kill cancer cells.
5. Immunotherapy: A treatment that uses the body's immune system to fight cancer.
The prognosis for rectal neoplasms depends on the type, location, and stage of the growth. In general, the earlier the diagnosis and treatment, the better the prognosis. However, some types of rectal neoplasms can be more aggressive and difficult to treat, and may have a poorer prognosis.
There is no sure way to prevent rectal neoplasms, but there are several screening tests that can help detect them early, including:
1. Colonoscopy: A test in which a flexible tube with a camera and light on the end is inserted into the rectum and colon to examine for polyps or cancer.
2. Fecal occult blood test (FOBT): A test that checks for blood in the stool.
3. Flexible sigmoidoscopy: A test similar to a colonoscopy, but only examines the lower part of the colon and rectum.
4. Digital rectal exam (DRE): An examination of the rectum using a gloved finger to feel for any abnormalities.
It is important to talk to your doctor about your risk for rectal neoplasms and any screening tests that may be appropriate for you. Early detection and treatment can improve the prognosis for these types of growths.
Explain how Capillary Leak Syndrome (CLS) can cause severe fluid and electrolyte imbalances in the body, leading to potentially life-threatening complications.
Capillary Leak Syndrome (CLS) is a rare but potentially devastating condition that affects the blood vessels and can cause severe fluid and electrolyte imbalances in the body. These imbalances can lead to a range of symptoms, from mild discomfort to life-threatening complications. In this essay, we will explore how CLS can cause fluid and electrolyte imbalances and discuss the potential risks associated with this condition.
Fluid and Electrolyte Imbalances in CLS:
The hallmark of CLS is the leakage of fluid from the blood vessels into the surrounding tissues, leading to an excessive accumulation of fluid in the interstitial space. This can cause a range of symptoms, including swelling (edema), shortness of breath, and abdominal pain. However, the most severe complication of CLS is the development of electrolyte imbalances, which can lead to life-threatening complications if left untreated.
Electrolytes are essential minerals that regulate a range of bodily functions, including fluid balance, nerve function, and muscle contraction. When the blood vessels leak fluid into the interstitial space, they also lose electrolytes, leading to an imbalance in the body's electrolyte levels. This can cause a range of symptoms, including muscle weakness, heart arrhythmias, and seizures. In severe cases, electrolyte imbalances can lead to respiratory failure, cardiac arrest, and even death.
Potential Risks Associated with CLS:
The potential risks associated with CLS are numerous and can be severe. The most common complications of CLS include:
1. Respiratory failure: The excessive accumulation of fluid in the lungs can lead to respiratory failure, which can be life-threatening if left untreated.
2. Cardiac arrhythmias: Electrolyte imbalances can cause abnormal heart rhythms, which can lead to cardiac arrest and even death.
3. Seizures: The loss of electrolytes can cause seizures, which can be difficult to control and can lead to serious complications.
4. Kidney damage: Prolonged fluid accumulation in the body can put a strain on the kidneys, leading to permanent damage and even failure.
5. Infection: The presence of fluid in the body can provide a breeding ground for bacteria, leading to serious infections such as sepsis and meningitis.
6. Compartment syndrome: The accumulation of fluid in the muscles can cause compartment syndrome, a condition that can lead to permanent nerve and muscle damage if left untreated.
7. Gangrene: In severe cases, the lack of blood flow to the tissues can lead to gangrene, which is the death of body tissue due to lack of blood supply.
8. Amputations: In severe cases, the loss of blood flow and oxygen to the tissues can lead to the need for amputation of affected limbs.
It is important to note that these risks are not limited to CLS, but can also be associated with other conditions that cause fluid accumulation in the body. It is essential to seek medical attention immediately if any of these symptoms occur, as prompt treatment can help mitigate these risks and improve outcomes.
Surgical wound infections can be caused by a variety of factors, including:
1. Poor surgical technique: If the surgeon does not follow proper surgical techniques, such as properly cleaning and closing the incision, the risk of infection increases.
2. Contamination of the wound site: If the wound site is contaminated with bacteria or other microorganisms during the surgery, this can lead to an infection.
3. Use of contaminated instruments: If the instruments used during the surgery are contaminated with bacteria or other microorganisms, this can also lead to an infection.
4. Poor post-operative care: If the patient does not receive proper post-operative care, such as timely changing of dressings and adequate pain management, the risk of infection increases.
There are several types of surgical wound infections, including:
1. Superficial wound infections: These infections occur only in the skin and subcutaneous tissues and can be treated with antibiotics.
2. Deep wound infections: These infections occur in the deeper tissues, such as muscle or bone, and can be more difficult to treat.
3. Wound hernias: These occur when the intestine bulges through the incision site, creating a hernia.
4. Abscesses: These occur when pus collects in the wound site, creating a pocket of infection.
Surgical wound infections can be diagnosed using a variety of tests, including:
1. Cultures: These are used to identify the type of bacteria or other microorganisms causing the infection.
2. Imaging studies: These can help to determine the extent of the infection and whether it has spread to other areas of the body.
3. Physical examination: The surgeon will typically perform a physical examination of the wound site to look for signs of infection, such as redness, swelling, or drainage.
Treatment of surgical wound infections typically involves a combination of antibiotics and wound care. In some cases, additional surgery may be necessary to remove infected tissue or repair damaged structures.
Prevention is key when it comes to surgical wound infections. To reduce the risk of infection, surgeons and healthcare providers can take several steps, including:
1. Proper sterilization and disinfection of equipment and the surgical site.
2. Use of antibiotic prophylaxis, which is the use of antibiotics to prevent infections in high-risk patients.
3. Closure of the incision site with sutures or staples to reduce the risk of bacterial entry.
4. Monitoring for signs of infection and prompt treatment if an infection develops.
5. Proper wound care, including keeping the wound clean and dry, and changing dressings as needed.
6. Avoiding unnecessary delays in surgical procedure, which can increase the risk of infection.
7. Proper patient education on wound care and signs of infection.
8. Use of biological dressings such as antimicrobial impregnated dressings, which can help reduce the risk of infection.
9. Use of negative pressure wound therapy (NPWT) which can help to promote wound healing and reduce the risk of infection.
10. Proper handling and disposal of sharps and other medical waste to reduce the risk of infection.
It is important for patients to follow their healthcare provider's instructions for wound care and to seek medical attention if they notice any signs of infection, such as redness, swelling, or increased pain. By taking these precautions, the risk of surgical wound infections can be significantly reduced, leading to better outcomes for patients.
Adenocarcinoma is a term used to describe a variety of different types of cancer that arise in glandular tissue, including:
1. Colorectal adenocarcinoma (cancer of the colon or rectum)
2. Breast adenocarcinoma (cancer of the breast)
3. Prostate adenocarcinoma (cancer of the prostate gland)
4. Pancreatic adenocarcinoma (cancer of the pancreas)
5. Lung adenocarcinoma (cancer of the lung)
6. Thyroid adenocarcinoma (cancer of the thyroid gland)
7. Skin adenocarcinoma (cancer of the skin)
The symptoms of adenocarcinoma depend on the location of the cancer and can include:
1. Blood in the stool or urine
2. Abdominal pain or discomfort
3. Changes in bowel habits
4. Unusual vaginal bleeding (in the case of endometrial adenocarcinoma)
5. A lump or thickening in the breast or elsewhere
6. Weight loss
8. Coughing up blood (in the case of lung adenocarcinoma)
The diagnosis of adenocarcinoma is typically made through a combination of imaging tests, such as CT scans, MRI scans, and PET scans, and a biopsy, which involves removing a sample of tissue from the affected area and examining it under a microscope for cancer cells.
Treatment options for adenocarcinoma depend on the location of the cancer and can include:
1. Surgery to remove the tumor
2. Chemotherapy, which involves using drugs to kill cancer cells
3. Radiation therapy, which involves using high-energy X-rays or other particles to kill cancer cells
4. Targeted therapy, which involves using drugs that target specific molecules on cancer cells to kill them
5. Immunotherapy, which involves using drugs that stimulate the immune system to fight cancer cells.
The prognosis for adenocarcinoma is generally good if the cancer is detected and treated early, but it can be more challenging to treat if the cancer has spread to other parts of the body.
Causes of cerebrospinal fluid rhinorrhea may include:
1. Skull fracture or depression: Trauma to the skull can cause a tear in the meninges, the membranes that cover the brain and spinal cord, leading to CSF leakage.
2. Spinal tap or lumbar puncture: This medical procedure can sometimes result in a small amount of CSF leaking into the nasopharynx.
3. Infection: Meningitis or encephalitis can cause CSF to leak into the nose and throat.
4. Brain tumors: Tumors in the brain can cause CSF to leak out of the sinuses or nose.
5. Cerebral aneurysm: A ruptured aneurysm in the brain can cause CSF to leak out of the nose or sinuses.
6. Vasculitic diseases: Conditions such as Wegener's granulomatosis or Takayasu arteritis can cause inflammation and damage to blood vessels, leading to CSF leakage.
7. Congenital conditions: Some individuals may have a congenital skull defect or abnormality that allows CSF to escape into the nasopharynx or sinuses.
Symptoms of cerebrospinal fluid rhinorrhea may include:
1. Clear, colorless discharge from the nose or sinuses
2. Thick, sticky discharge or pus in the nose or sinuses
3. Headache, fever, or neck stiffness
4. Nausea, vomiting, or dizziness
5. Weakness or numbness in the face, arms, or legs
6. Seizures or convulsions
7. Change in mental status or consciousness
Diagnosis of cerebrospinal fluid rhinorrhea typically involves a combination of physical examination, imaging studies such as CT or MRI scans, and laboratory tests to rule out other possible causes of nasal discharge. Treatment depends on the underlying cause of the condition and may include antibiotics, anti-inflammatory medications, or surgery to repair any defects or obstructions in the skull or sinuses.
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Linda Zhang - Publications & Research Outputs - Icahn School of Medicine at Mount Sinai
- Complications after colorectal surgery remain inevitable, and anastomotic leakage is one of the most severe and potentially fatal complications. (coloproctol.org)
- Generally, anastomotic leakage is associated with severe peritonitis, the need for emergency reoperation, and an increased mortality rate. (coloproctol.org)
- To prevent anastomotic leakage, understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure are important. (coloproctol.org)
- Furthermore, the blood flow evaluation method for the reconstructive colon before anastomosis, which is extremely important in anastomotic leakage prevention regardless of the anastomotic type, is also described. (coloproctol.org)
- EUA and pouchogram were concordant in two patients (n = 1 anastomotic complication, n = 1 pouch septum) and ileostomy reversal was delayed. (duke.edu)
- Short-term complications occurred in 34% with reoperation in 5: obstruction n = 3, anastomotic leak n = 2. (elsevier.com)
- Because factor XIII promotes cross-linking of fibrin during the early phase of wound healing , we investigated the effect of factor XIII concentrate on 16 anastomotic leaks and a nonhealing fistula . (bvsalud.org)
- Our findings suggest that factor XIII significantly accelerates wound healing of anastomotic leaks and nonhealing fistulas by increasing circulating growth factors after systemic administration . (bvsalud.org)
- Rotura de la conexión y escape consiguiente (líquidos, secreciones, aire) en una ANASTOMOSIS QUIRÚRGICA en las estructuras del aparato digestivo, respiratorio, genitourinario y vascular. (bvsalud.org)
- Los escapes más frecuentes proceden de roturas de las líneas de sutura en el tubo digestivo y anastomosis intestinales. (bvsalud.org)
- In this article, we describe the DST, SST, and hand-sewn anastomosis as anastomotic techniques after rectal surgery, focusing mainly on the differences between conventional anastomotic techniques and SST in TaTME. (coloproctol.org)
- Anastomotic leak (most commonly from the pancreaticojejunal anastomosis). (mhmedical.com)
- In the remaining symptomatic patient, pouchogram detected an anastomotic leak where EUA detected only a stricture, and this prompted a delay in reversal. (duke.edu)
- Take an x-ray to look for leaks from the stomach pouch. (epnet.com)
- Transanal total mesorectal excision (TaTME) is a relatively new advanced surgical access technique for pelvic dissection and facilitates different anastomotic techniques without the need for transabdominal rectal transection. (coloproctol.org)
- Enhanced recovery strategies, prehabilitation and frailty, prophylactic approaches and avoidance of anastomotic leak will be covered, as will the management of pelvic sepsis, hernia and the abdominal catastrophe. (ecco-ibd.eu)
- Roux-en-Y gastric bypass is surgery to decrease the structure and size of the stomach and attach it to a small part of the intestine. (epnet.com)
- One of 50 (2%) asymptomatic patients with normal pouchogram had anastomotic dehiscence found on EUA. (duke.edu)
- BACKGROUND: The non-steroidal anti-inflammatory drug diclofenac has been associated with intestinal anastomotic leakage, although the underlying pathophysiology is unclear. (nih.gov)
- Here, the microbial glucuronidase inhibitor Inh1 was examined for its ability to reduce diclofenac-induced anastomotic leakage in rats. (nih.gov)
- Outcomes were anastomotic leakage, leak severity, and anastomotic strength. (nih.gov)
- 1. There is no correlation between a delayed gastric conduit emptying and the occurrence of an anastomotic leakage after Ivor-Lewis esophagectomy. (nih.gov)
- 4. Improved anastomotic leakage rates after the "flap and wrap" reconstruction in Ivor Lewis esophagectomy for cancer. (nih.gov)
- 14. Management and outcome of cervical versus intrathoracic manifestation of cervical anastomotic leakage after transthoracic esophagectomy for cancer. (nih.gov)
- Additionally, there are specific concerns such as "tip of the J" leaks, transanal management of anastomotic leak/presacral sinus, functional outcomes after leak, and considerations of redo pouch procedures. (nih.gov)
- RESULTS: Anastomotic leak rates were 89% in group DCF and 44% in group DCF-Inh1 (p = 0.006). (nih.gov)