Gastric perforation after duodenopancreatectomy.
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ABSTRACT:
SUBMITTER: Backer H
PROVIDER: S-EPMC5536876 | biostudies-other | 2017 Dec
REPOSITORIES: biostudies-other
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Project description:Intragastric balloon (IGB) insertion has been most frequently used in the West as an effective endoscopic treatment for morbid obesity, in practice. Recently, there is a growing number of cases requiring IGB deployment for obesity treatment in Korea. One of the reported complications of IGB use is gastric perforation. A 47-year-old woman was admitted to the hospital with mild symptoms, 7 weeks after having an IGB placed. Esophagogastroduodenoscopy was performed and gastric ulcer perforation was observed in the ulcer base, where food particles were impacted. Laparoscopic primary repair was done successfully. This was a case of gastric perforation, secondary to poor compliance with a proton-pump inhibitor (PPI). PPI and Helicobacter pylori eradication are important for ulcer prevention following IGB deployment.
| S-EPMC5719922 | biostudies-literature
Project description:Development of biocompatible hydrogel adhesives with robust tissue adhesion to realize instant hemorrhage control and injury sealing, especially for emergency rescue and tissue repair, is still challenging. Herein, we report a potent hydrogel adhesive by free radical polymerization of N-acryloyl aspartic acid (AASP) in a facile and straightforward way. Through delicate adjustment of steric hindrance, the synergistic effect between interface interactions and cohesion energy can be achieved in PAASP hydrogel verified by X-ray photoelectron spectroscopy (XPS) analysis and simulation calculation compared to poly (N-acryloyl glutamic acid) (PAGLU) and poly (N-acryloyl amidomalonic acid) (PAAMI) hydrogels. The adhesion strength of the PAASP hydrogel could reach 120 kPa to firmly seal the broken organs to withstand the external force with persistent stability under physiological conditions, and rapid hemostasis in different hemorrhage models on mice is achieved using PAASP hydrogel as physical barrier. Furthermore, the paper-based Fe3+ transfer printing method is applied to construct PAASP-based Janus hydrogel patch with both adhesive and non-adhesive surfaces, by which simultaneous wound healing and postoperative anti-adhesion can be realized in gastric perforation model on mice. This advanced hydrogel may show vast potential as bio-adhesives for emergency rescue and tissue/organ repair.
| S-EPMC9117276 | biostudies-literature
Project description:Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637-641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and literature review.A 46 year old lady with metastatic invasive ductal breast cancer was admitted to A&E with sudden onset of epigastric and left shoulder pain. She completed the first cycle of capecitabine/vinorelbine 1 week previously. Clinical examination revealed a tender epigastrium with rigidity in the upper abdomen. Free air under the diaphragm and a positive Rigler's sign was radiologically identified. A laparoscopy demonstrated a fibrinous exudate in the left upper quadrant consistent with a walled off lesser curvature gastric perforation. A subsequent oesophagogastroduodenoscopy (OGD) demonstrated a healed gastric ulcer of benign appearance; however the pathology confirmed metastatic breast carcinoma.Literature review confirmed no previously reported cases of vinorelbine induced gastric perforation. Four cases of metastatic breast cancer with gastric metastasis presenting with perforation were identified; three of these cases (Fra et al., Presse Med 25(26):1215 (1996) [2], Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91-92 (2004) [3], Ghosn et al., Bull Cancer 78(11):1071-1073 (1991) [4]), were in the French medical literature, including one male patient (Fra et al., Presse Med 25(26):1215 (1996) [2]) and at least one ductal breast carcinoma (Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91-92 (2004) [3]). The fourth case (van Geel et al., Ned Tijdschr Geneeskd 144(37):1761-1763 (2000) [5]), was in the Dutch medical literature and a lobular breast carcinoma.This case represents a rare complication of breast cancer chemotherapy, the subsequent significant benefit the patient received from treatment is consistent with the chemosensitivity to therapy that also resulted in gastric perforation. Five years after gastric perforation she resumed palliative chemotherapy after progression on sequential hormonal therapies.
| S-EPMC5550518 | biostudies-other
Project description:Gastrostomy creation is a common procedure in paediatric surgery. It provides enteral nutrition to patients who cannot achieve adequate nutrition by mouth. Common indications of gastrostomy placement in children include syndromic or neurodevelopmental diseases, severe malformations of the aerodigestive tract, craniofacial abnormalities, and intractable gastroesophageal reflux disease with recurrent aspiration. It is also indicated in patients who suffer from failure to thrive and require extra caloric intake. In contrast to adults, paediatric patients have a weaker ability to complain about problems with their gastrostomy tubes when they occur, in particular when some of these neurological patients are non-communicable. Complications may arise when migration of the catheter goes unnoticed, causing obstruction. Due to the smaller stomach size, thinner gastric wall and narrower gastric outlet in paediatric patients, obstruction from the gastrostomy balloon may result in serious sequelae. Here we present two unusual but serious complications of gastrostomy tubes causing suspected duodenal obstruction and subsequent gastric perforation in paediatric patients, requiring emergency operations. Furthermore, we would like to emphasize the importance of proper gastrostomy tube care and alert the caretakers of the potential sinister complications that can arise. We would also like to take this opportunity to suggest measures to prevent their occurrence.
| S-EPMC8349959 | biostudies-literature
Project description:INTRODUCTION:This is an original case series on soldiers evacuated from HAA(High Altitude Area) over last one year(Sept 2017-Aug 2018), of which 100% cases were found to have gastric antrum perforation. This is a deviation from the usual trend that is being noted in Indian subcontinent where duodenal perforations are commonest. DISCUSSION:High altitude associated dyspepsia is a common phenomenon and some studies done in high altitude population have recorded high incidence of antral gastritis and mucosal atrophy on histo-pathological evaluation. This is also supported by high incidence of H. pylori infection. The presence of atrophic gastric mucosa associated with antral gastritis, when exposed to hypobaric hypoxemic conditions faced by soldiers posted to heights above 15,000?ft, may leads to increased intra-luminal pressure and ischemia which probably predisposes individuals for gastric antrum perforations. CONCLUSION:This is a relatively untouched topic as we have not found studies onhigh altitude related gastric perforations and probably this is the first case series of its kind. The acknowledgement of this phenomenon may pave way for further studies for defining the role of high altitude in gastric perforations.
| S-EPMC6262768 | biostudies-literature
Project description:We describe a case of a patient with an intrathoracic gastric perforation, 6 months after she underwent a gastric banding procedure for the treatment of morbid obesity. After an urgent laparotomy during which the stomach was replaced and oversewn, she recovered uneventfully. The possible mechanism of this severe complication is discussed.
| S-EPMC2367390 | biostudies-other
Project description:BackgroundPrimary lymphomas of the gastrointestinal tract are rare, accounting for only 1 to 4% of malignancies arising in the stomach, small intestine, or colon. The stomach is the most common extranodal site of lymphoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma accounts for 40% of primary gastric lymphoma. Gastric MALT lymphoma reaches its peak incidence between 50 to 60?years of age, therefore, it is rarely encountered in pediatric population. The presenting symptoms of gastric MALT lymphoma are usually nonspecific and primary perforation of gastric MALT lymphoma is uncommon.Case presentationA 12?year-old female presented with iron deficient anemia developed gastric perforation. Emergency laparoscopic repair of the perforation was performed and tissue pathology showed gastric MALT lymphoma infiltration. Helicobacter pylori eradication and radiotherapy were sequentially performed. Complete remission was achieved at two months after radiotherapy. To our best knowledge, she is the youngest patient with gastric MALT lymphoma reported in the literature.ConclusionIron deficient anemia is a common presenting manifestation of malignancies in adulthood. In pediatric population, iron deficient anemia is usually caused by nutritional deficient or blood loss. In this case report, we present a teenaged female without previous gastric ulcer history who presented with a rare gastric tumor and an uncommon primary perforation. Even if there is an uncertainty about the exact diagnosis prior to the surgery, the strategy of stomach-preserving therapy by laparoscopy for primary perforation was successful and provided a good quality of life.
| S-EPMC6380025 | biostudies-literature
Project description:BackgroundGastrointestinal perforation is commonly seen in emergency departments. The perforation of the stomach is an emergency situation that requires immediate surgical treatment. The necessary surgical skills require regular practical training. Owing to patient`s safety, in vivo training opportunities in medicine are restricted. Animal tissue especially porcine tissue, is commonly used for surgical training. Due to its limiting factors, artificial training models are often to be preferred. Many artificial models are on the market but to our knowledge, none that mimic the haptic- and sewing properties of a stomach wall at the same time. In this study, an open source silicone model of a gastric perforation for training of gastric sewing was developed that attempts to provide realistic haptic- and sewing behaviour.MethodsTo simulate the layered structure of the human stomach, different silicone materials were used to produce three different model layups. The production process was kept as simple as possible to make it easily reproducible. A needle penetration setup as well as a systematic haptic evaluation were developed to compare these silicone models to a real porcine stomach in order to identify the most realistic model.ResultsA silicone model consisting of three layers was identified as being the most promising and was tested by clinical surgeons.ConclusionsThe presented model simulates the sewing characteristics of a human stomach wall, is easily reproducible at low-costs and can be used for practicing gastric suturing techniques.Trial registrationsNot applicable.
| S-EPMC10116820 | biostudies-literature