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Walled-off Pancreatic Necrosis Treated with Video-Assisted Retroperitoneal Debridement (VARD)
Gustavo Adolfo Guerrero Martínez,
Luis Gerardo Aguilera Muñoz,
Maryel Sánchez Olvera
Issue:
Volume 10, Issue 5, October 2022
Pages:
144-148
Received:
21 March 2022
Accepted:
11 April 2022
Published:
29 September 2022
DOI:
10.11648/j.js.20221005.11
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Abstract: Acute pancreatitis is Pancreas inflamatory process that should be suspected in patients with severe acute abdominal pain in the upper quadrants, mainly in the epigastrium. However, to diagnose it, laboratory and imaging studies are necessary and two of the following criteria are required: abdominal pain consistent with the disease, serum amylase or lipase elevated more than three times the upper limit of normal and strongly suggestive images (US, CT, MRI). Up to 10-20% of cases of severe pancreatitis will develop necrosis of the gland and its peripheral tissues, generating a slow and torpid evolution with tendency to clinical deterioration, carrying the patient to mortality of up to 20-40% when associated with infection. In these cases, an invasive approach is mandatory in order to extract the fluid from inside the collection and/or necrotic tissue. Minimally invasive techniques such as percutaneous or endoscopic drainage, endoscopic necrosectomy, and video-assisted pancreatic necrosectomy (VARD) have been proposed, due to the high rate of morbidity and mortality that open necrosectomy carries; however, it is still used when minimally invasive management does not solves the problem. In this article we present the case of a 56-year-old patient with moderate acute pancreatitis of biliary origin, complicated by infected pancreatic necrosis, being managed with VARD, presenting an adequate postoperative evolution.
Abstract: Acute pancreatitis is Pancreas inflamatory process that should be suspected in patients with severe acute abdominal pain in the upper quadrants, mainly in the epigastrium. However, to diagnose it, laboratory and imaging studies are necessary and two of the following criteria are required: abdominal pain consistent with the disease, serum amylase or...
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Magnitude and Pattern of Anorectal Problems Among Patients Attending Surgical Departments of Public Hospitals in Addis Ababa, Ethiopia
Adane Haile,
Trhas Tadesse,
Ephrem Mamo,
Daniel Zemefense,
Zelalem Assefa
Issue:
Volume 10, Issue 5, October 2022
Pages:
149-156
Received:
17 August 2022
Accepted:
13 September 2022
Published:
29 September 2022
DOI:
10.11648/j.js.20221005.12
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Abstract: Background: Anorectal disorders include a diverse group of pathological disorders that generate significant patient discomfort and disability. Anorectal disorders are a common reason for visits to both primary care physicians and gastroenterologists. These disorders are varied and include benign condition such as hemorrhoids to more serious condition such as malignancy. Method: cross-sectional study with quantitative approach was deployed to identify the magnitude and pattern of anorectal problems. A total of 1174 adult patients (15 & above years old) visiting emergency and regular surgical OPD was included. Frequency tables and graphs were used to describe the study variables. A logistic regression model was used to measure the association between the predictors and Anorectal malformation, and a P-value < 0.05 was accepted as statistically significant. OR and 95% CI were used to express the direction and strength of the association. Result: One hundred ninety-five (16.6%) CI at 95% (14.5, 18.7) of the study participants had Anorectal problem. Among patients with Anorectal problems, 118 (60.5%) were males & 77 (52.3%) were females. Majority of them 145 (52.3%) are above 30 years. Among diagnosed with Anorectal problems more than half 118 (60.5%) of the problem were hemorrhoid, 73 (37.4%) of the patients were presented with complain of anal pain, and 37 (19.2%) of them with swelling in the anus. Female patients were less likely to develop Anorectal problems than male patients (AOR = 0.67, 95% CI: 0.44, 0.99). More over patient with occupation others like solider, factory worker, shop keeper, office worker, driver were more likely to develop Anorectal problems than patients with occupational status of student (AOR = 4.9, 95% CI: (1.55, 15.82). Conclusion: The goal of this study was to provide base line data on the pattern and magnitude of Anorectal problems based on the data obtained from public hospitals of the capital city of Ethiopia. The magnitude of Anorectal problems is high among surgical patients and sex, occupation and education status are significantly associated with Anorectal problems.
Abstract: Background: Anorectal disorders include a diverse group of pathological disorders that generate significant patient discomfort and disability. Anorectal disorders are a common reason for visits to both primary care physicians and gastroenterologists. These disorders are varied and include benign condition such as hemorrhoids to more serious conditi...
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Advances in Computer-Assisted Robotic Knee Replacement Surgical Methods
Issue:
Volume 10, Issue 5, October 2022
Pages:
157-163
Received:
21 August 2022
Accepted:
14 September 2022
Published:
29 September 2022
DOI:
10.11648/j.js.20221005.13
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Abstract: TKA (total knee arthroplasty) is one of the most prevalent operations among the treatments for patients who suffer from OA (osteoarthritis) of the knee. The postoperative patient satisfaction rates for TKA remain lower than expected despite the procedure being one of the most successful in orthopedics with excellent survivorship. In recent years, the development of technology in surgical techniques has caused robotic-assisted methods to become more popular. Surgical robots have increased the number of robotic-assisted TKA operations due to fewer postoperative pains, quicker recovery times, and shorter hospital stays. According to this theory, the amount of bone resection and soft tissue damage, both significant pain sources, will be minimized with this technology. Through the use of robotic assisted systems, surgeons can achieve consistent surgical outcomes using a minimally invasive operating environment that eliminates the uncertainty associated with knee arthroplasty. Our study aimed to investigate the importance of this method of surgery, advances new techniques, the clinical outcomes and postoperative results, and the management of the operation. Restrictions of RATKA (Robotic Assisted Total Knee Arthroplasty) include high installation costs and learning techniques for gaining surgical skills, and compatibility of the robotic technology with a limited number of implant designs.
Abstract: TKA (total knee arthroplasty) is one of the most prevalent operations among the treatments for patients who suffer from OA (osteoarthritis) of the knee. The postoperative patient satisfaction rates for TKA remain lower than expected despite the procedure being one of the most successful in orthopedics with excellent survivorship. In recent years, t...
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Laparoendoscopic Cystogastric Bypass of a Pancreatic Necrosis: Case Report and Surgical Technique
Luis Miguel Carrillo,
Claudia Teresa Barba-Valadez,
David Ramirez-Reyes,
Jose Augusto Rodriguez-Osuna,
Cristina Elizabeth Mora-Montoya,
Jesus Alejandro Olvera-Rodriguez,
Laura Yazmin Gutierrez-Gutierrez,
Jacaranda Herrera-Gutierrez
Issue:
Volume 10, Issue 5, October 2022
Pages:
164-167
Received:
26 July 2022
Accepted:
9 August 2022
Published:
11 October 2022
DOI:
10.11648/j.js.20221005.14
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Abstract: The incidence of acute pancreatitis (AP) is increasing, up to 0.7 hospitalizations per 1,000 inhabitants in the U.S. In 80% of patients, AP is mild and self-limited, but up to 20% of patients may have a severe necrotizing course, responsible for substantial morbidity and a mortality rate of up to 27%. The main cause of death is necrosis infection, which is associated with a poor prognosis with a mortality of 15% to 39%. Until very recently, the gold standard for treating infected necrosis used to be surgical necrosectomy by laparotomy. This procedure provides wide access to infected necrosis but is highly invasive and is associated with morbidity rates of 34% to 95% and mortality rates of 11% to 39%. Alternative methods primarily involve debridement using retroperitoneal, laparoscopic, endoscopic, or combinations of these. They share the common goal of avoiding laparotomy and together are known as "minimally invasive necrosectomy." These techniques continue to evolve and undergo refinement. To date there is no evidence or randomized trials comparing these techniques with traditional “open” necrosectomy or, equally important, comparing different minimally invasive necrosectomy techniques with each other. This presents a problem for surgeons dealing with patients with pancreatic necrosis as they need to consult the available evidence to guide the selection of their treatment. This case provides a concise but general description of a minimally invasive approach to a pancreatic pseudocyst in a man with a history of alcoholic pancreatitis, with special reference to the surgical technique, the postoperative result and, above all, to point out the benefits of this type of approach.
Abstract: The incidence of acute pancreatitis (AP) is increasing, up to 0.7 hospitalizations per 1,000 inhabitants in the U.S. In 80% of patients, AP is mild and self-limited, but up to 20% of patients may have a severe necrotizing course, responsible for substantial morbidity and a mortality rate of up to 27%. The main cause of death is necrosis infection, ...
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Safety and Performance of the HD1000i Shears in Urologic Procedures: A Retrospective Review
Mordechai Goode Sadowsky,
Won Sik Jang,
Subin Lim,
DongKyu Kim,
Jason Robert Waggoner,
Philippe Grange,
Paula Priscilla Veldhuis,
Giovanni Antonio Tommaselli
Issue:
Volume 10, Issue 5, October 2022
Pages:
168-174
Received:
7 September 2022
Accepted:
21 September 2022
Published:
11 October 2022
DOI:
10.11648/j.js.20221005.15
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Abstract: Background: Ultrasonic devices including the Harmonic HD1000i Shears are utilized for incision, dissection, and separation and division of tissues to achieve hemostatic transection of vessels in a wide range of procedures. This study was conducted to further evaluate the safety and performance of the HD1000i in a clinical setting use during urologic procedures. Methods: The primary endpoint of this retrospective, observational, single-arm study was intra- and post-operative transfusions deemed related to study device. Secondary endpoints were occurrences of intra-operative and post-operative adverse events (AEs) or complications possibly related to the procedure or device. Adult patients who underwent open cystectomy (OC), or laparoscopic (LN) or open nephrectomy (ON) from May 1, 2018 to November 30, 2020 at Severance Hospital (South Korea) where the device had been utilized (without the use of alternative advanced energy device used) were included in this study. Results: One-hundred and five subjects met inclusion criteria: 48 in OC, 18 in ON, and 39 in LN. Overall blood transfusion rates were 52.1% (25/48), 38.9% (7/18), and 5.1% (2/39) for the OC, ON, an LN groups, respectively, and 32.4% (34/105) overall. AE’s/complications were reported in 2.9% of subjects: one in the ON group (6%) and 2 in the LN subset (5%). Conclusion: Analysis of a single institution’s experience with the Harmonic HD1000i device in urologic surgery demonstrates acceptable safety and efficacy comparable to the published literature.
Abstract: Background: Ultrasonic devices including the Harmonic HD1000i Shears are utilized for incision, dissection, and separation and division of tissues to achieve hemostatic transection of vessels in a wide range of procedures. This study was conducted to further evaluate the safety and performance of the HD1000i in a clinical setting use during urologi...
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Cases of Spontaneous Pneumothorax in Patients with New Coronavirus Disease SARS-CoV-2 COVID-19
Issue:
Volume 10, Issue 5, October 2022
Pages:
175-179
Received:
27 April 2022
Accepted:
26 September 2022
Published:
18 October 2022
DOI:
10.11648/j.js.20221005.16
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Abstract: For the third year after the announcement of the COVID-19 pandemic (March 11, 2020), the main focus of research on the manifestations of this new coronavirus disease is pneumonia and acute respiratory distress syndrome. Meanwhile, COVID-19 promotes the development of surgical lung diseases that require immediate surgical intervention. In particular, with COVID-19, the development of "spontaneous" pneumothorax is possible as a direct consequence of lung tissue damage by the SARS-CoV-2 COVID-19 virus. This report presents case histories of four male and female (one individual) patients with so-called "spontaneous" pneumothorax, which appeared to be a direct complication of the novel coronavirus disease, COVID-19. The author of the article also cites the possible causes of this complication in pneumonia (pneumonitis) caused by the SARS-CoV-2 COVID-19 virus, which, unlike pneumonia caused by influenza viruses and other previously known coronaviruses, directly affects the small arteries of the lungs, which leads to a violation nutrition and, as a result, to local necrosis of lung tissue. The localization of lung lesions plays a certain role in the occurrence of pneumothorax with this new coronavirus disease. Thus, this article will try to prove that the occurrence of pneumothorax with COVID-19 is a rare but completely natural complication of the new coronavirus disease SARS-CoV-2 COVID-19.
Abstract: For the third year after the announcement of the COVID-19 pandemic (March 11, 2020), the main focus of research on the manifestations of this new coronavirus disease is pneumonia and acute respiratory distress syndrome. Meanwhile, COVID-19 promotes the development of surgical lung diseases that require immediate surgical intervention. In particular...
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A Giant Lipoblastoma in a 13-month-old Girl: A Case Report
Maamatou Wafa,
Trabelsi Fatma,
Jarray Leila,
Daib Aida,
Ben Abdallah Rabiaa,
Jabloun Asma,
Hellel Youssef,
Gharbi Youssef,
Kaabar Nejieb
Issue:
Volume 10, Issue 5, October 2022
Pages:
180-183
Received:
14 February 2022
Accepted:
11 October 2022
Published:
28 October 2022
DOI:
10.11648/j.js.20221005.17
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Abstract: Lipoblastoma is a relatively rare benign soft tissue tumor. It most often occurs in the small child, less than 3 years old. There is a male predominance with a sex ratio of 3/1. Lipoblastoma usually present as a rapidly growing mass most often located in the trunk and extremities. It is extremely rare on the head and neck. Usually, this tumor is asymptomatic, but it can become so due to its size and location. The contribution of imaging is essential in the diagnostic approach of this tumor. Essentially, MRI confirms the fatty nature of the tumor and the heterogeneous aspect in relation to the enhancement of the fibrovascular septa. However, the definitive diagnosis is histopathological through a surgical biopsy, which eliminates a malignant tumor at the same time. The treatment of choice is complete surgical resection of the tumor. No malignant degeneration has been documented while a high recurrence rate has been described and is usually correlated to the diffuse-type lesions (lipoblastomatosis) and to incomplete excision. We report the case of a 13-month-old girl presented with a swelling of the left buttock that had been evolving for 4 months, with a very significant increase in size during the last month. The diagnosis of lipoblastoma was suspected clinically and on radiological explorations. This diagnosis confirmed histologically. The treatment was surgical. It consisted in a total resection of the mass. The postoperative evolution was simple with a current follow-up of one year.
Abstract: Lipoblastoma is a relatively rare benign soft tissue tumor. It most often occurs in the small child, less than 3 years old. There is a male predominance with a sex ratio of 3/1. Lipoblastoma usually present as a rapidly growing mass most often located in the trunk and extremities. It is extremely rare on the head and neck. Usually, this tumor is as...
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Lymphedema: Anatomoclinical Aspects and Surgical Management at the Ignace Deen National Hospital of Conakry (Guinea)
Kondano Saa Yawo,
Fofana Naby,
Bangoura Mohamed Saliou,
Koundouno Aly Mampan,
Camara Mariame,
Diallo Mariama Cire,
Guirassy Mariame,
Camara Naby Laye Youssouf,
Kamano Faya Anatole,
Diallo Alseny,
Oulare Ibrahima,
Soumaoro Labile Togba,
Toure Aboubacar,
Diallo Aissatou Taran
Issue:
Volume 10, Issue 5, October 2022
Pages:
184-186
Received:
14 September 2022
Accepted:
18 October 2022
Published:
28 October 2022
DOI:
10.11648/j.js.20221005.18
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Abstract: Introduction: We aimed to report the anatomoclinical aspects and the management of lymphedema in the general surgery department at Ignace Deen National Hospital of Conakry (Guinea). Patients and methods: this was a retrospective study including consecutive patients with lymphoedema who were admitted and had surgery in our department during a period of 10 years (from January 2010 to December 2019). Results: during the ten years we collected 25 cases of lymphedema: 11 male and 14 females. The mean age of the patients was 45 years-old. The disease onset varies from 6 months to 18 years with a mean of 7.5 years. The lesions were predominantly in the limbs (76%) and in the genitalia (24%). The microfilaria test was negative. All patients received an anti-filarial drug (diethylcarbamazine) as a precautionary measure. The procedure consisted of resection of the lymphangiomatous tissue and a reconstruction plasty. After a 2-year follow-up we did not observe any case of recurrence. Conclusion: Lymphedema is a rare pathology in our environnement that occurs predominantly in the limbs and genitalia. This disease has a significant impact on the quality of life of patients, the functional, aesthetic and psychological repercussions. A well performed excisional surgery with reconstruction allow a satisfactory result.
Abstract: Introduction: We aimed to report the anatomoclinical aspects and the management of lymphedema in the general surgery department at Ignace Deen National Hospital of Conakry (Guinea). Patients and methods: this was a retrospective study including consecutive patients with lymphoedema who were admitted and had surgery in our department during a period...
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Difficulties of Surgery in the Management of an Inflammatory Zenker's Diverticula: Report of an Observation
Bangoura Mohamed Saliou,
Bouraoui Ridjial Hadar,
Toure Alpha Oumar,
Yattara Abdoulaye,
Seck Mamadou,
Cisse Mamadou,
Soumaoro Labilé Togba,
Toure Aboubacar,
Dieng Madieng
Issue:
Volume 10, Issue 5, October 2022
Pages:
187-189
Received:
16 September 2022
Accepted:
18 October 2022
Published:
28 October 2022
DOI:
10.11648/j.js.20221005.19
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Abstract: Introduction: Zenker’s diverticulum is a rare pathological entity characterized as is a herniation of the pharyngoesophageal mucosa by impulse, developed through a dehiscence of the muscular wall of the pharyngoesophageal junction located above the upper esophageal sphincter. The mainly digestive symptomatology is a high dysphagia with regurgitation. For patients with symptoms, surgery remains the only treatment option. The objective of this work was to highlight the difficulties of surgery in the management of an inflammatory zenker’s diverticulum managed in the general surgery department of the Aristide Le Dantec hospital. Observation: herein we reported the observation of 61-year-old hypertensive patient known to be on treatement, dialyzed for 5 years for chronic end-stage renal faillure, referred from nephrology for the management of an inflamed zenker s diverticulum. She had performed a cervical tomodensitometry and a barium enema which come back in favor of a zenker’s diverticulum, she benefited from a suture of the neck of the diverticulum and the aftemath was enamelled with complications of pneumopathy. Conclusion: Zenker’s diverticulum is a rare pathology occurring in the elderly. The diagnosis is suggested by certain clinical signs such as regurgitation and dysphagia; the definitive treatment remains surgery.
Abstract: Introduction: Zenker’s diverticulum is a rare pathological entity characterized as is a herniation of the pharyngoesophageal mucosa by impulse, developed through a dehiscence of the muscular wall of the pharyngoesophageal junction located above the upper esophageal sphincter. The mainly digestive symptomatology is a high dysphagia with regurgitatio...
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Double Stangulation by an Ileosigmoid Knot About an Observation and Review of the Literature
Bangoura Mohamed Saliou,
Bouraoui Ridjial Hadar,
Fofana Aminata,
Youla Alpha Mohamed,
Yattara Abdoulaye,
Soumaoro Labile Togba,
Toure Aboubacar
Issue:
Volume 10, Issue 5, October 2022
Pages:
190-192
Received:
19 September 2022
Accepted:
18 October 2022
Published:
28 October 2022
DOI:
10.11648/j.js.20221005.20
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Abstract: Introduction: Occlusions by ileo-sigmoid nodes are rare etiologies of occlusions by strangulation, which can quickly engage the vital prognosis if the management is not early. Patient and observation: herein we reported case of an acute intestinal obstruction by ileo-sigmoid node observed at the regional hospital of Ndioum in the north of Senegal. A patient of 35 years old without any particular history was sent to us for the management of a syndrome of peritoneal irritation. On admission there was abdominal distension with hypogastric arch, diffuse abdominal tenderness, with abdominal meteorism. She performed a plain x-ray of the abdomen which was not diagnostically helpful. She benefited from an exploratory laparotomy during which we highlighted a double grelic and colonic strangulation by an ileo-sigmoid knot, a double grelic and colonic resection was performed and the postoperative course was simple. Conclusion: Occlusion by ileo-sigmoid node is a very rare condition, characterized by its clinico-radiological polymorphism, which also means that the diagnosis is made late. Surgical treatment remains the cornerstone of the management of this condition.
Abstract: Introduction: Occlusions by ileo-sigmoid nodes are rare etiologies of occlusions by strangulation, which can quickly engage the vital prognosis if the management is not early. Patient and observation: herein we reported case of an acute intestinal obstruction by ileo-sigmoid node observed at the regional hospital of Ndioum in the north of Senegal. ...
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