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The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
These include strangulation of bowel in a hernia sac (see Figure 10.41) and volvulus. The latter is an apparently spontaneous twist in a loop of bowel (often small intestine or sigmoid colon). This may occur around a congenital or acquired fibrous adhesion or as a result of an unusually long mesentery. Volvulus and strangulation lead to luminal obstruction and eventually to infarction by venous thrombosis. Intussusception is an invagination of one bowel segment into another. There is usually a lesion at the apex of the invaginating bowel. This may be a polyp or an intramural tumour, or something as simple as a focus of lymphoid hyperplasia. The hyperplasia is usually the case in ileocolic intussusception, the most common type seen in clinical practice.
Neonatal and General paediatric Surgery
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Intussusception occurs in 1 in 250 infants. An intussusception consists of invagination of one part of the intestine into the adjacent bowel. This causes an incomplete obstruction which, if unrelieved, leads to complete obstruction together with impairment of the vascularity to the invaginated (intussusceptum) bowel, initially venous congestion but ultimately ischaemic necrosis. The ileocaecal region is the most common site but any portion of the intestinal tract may be involved.
Fecal Incontinence, Physical Examination
Published in Han C. Kuijpers, Colorectal Physiology: Fecal Incontinence, 2019
The diagnosis of internal prolapse is often delayed and difficult to demonstrate on physical examination. Ulceration, mucosal edema, erythema, or proctitis may incorrectly lead the physician to the diagnosis of inflammatory bowel disease. Internal prolapse can best be demonstrated by asking the patient to strain during withdrawal of the rigid proctoscope. The invagination of the bowel is readily visualized and may be followed downward as the scope is slowly withdrawn. But the most effective diagnostic method for intussusception is defecography. Barium enema or colonoscopy need not be performed routinely unless indicated, since diagnostic yield is low in evaluation of anal incontinence.
Indications and complications of secondary tracheoesophageal puncture in Chinese laryngectomees
Published in Acta Oto-Laryngologica, 2022
Chunping Wu, Duo Zhang, Xiaohui Yuan, Ling Chen, Lei Tao
Complications of secondary TEP can be divided into intraoperative and postoperative complications. Intraoperative complications are related to the surgical operation, with serious complications including esophageal perforation and vertebral body fractures [15–17], most of which are caused by violent cervical overextension and violent insertion of rigid esophagoscope due to limited mobility of cervical spine. Postoperative complications are related to tracheoesophageal fistula [5,18] and are mostly mild, including leakage around prosthesis (19.1%), deglutition of prosthesis (7–12.7%), invagination and incarceration and of prosthesis (9%), granulation tissue formation (4.2–7%) and local cellulitis (8%). Serious complications include mediastinitis (3%) and paraesophageal abscess (3%).
Endoureterotomy with the Lovaco technique for treatment of ureterointestinal strictures: outcomes in an experienced center and factors associated with procedural success or failure
Published in Scandinavian Journal of Urology, 2022
Jorge Panach-Navarrete, Lorena Valls-González, José María Martínez-Jabaloyas
To our knowledge, the present study is the first since the 2005 Lovaco study of endoureterotomy with intraluminal invagination to reproduce the procedure and present outcomes with the same sample size as the original publication [9]. In our view, this surgery demonstrates significant advantages, such as performability without using flexible endoscopic material, additional safety provided by intraluminal invagination of the stricture, and the convenience of approaching the stricture from the wide space afforded by the intestinal diversion compared to antegrade access from the ureter. After 30 procedures and 35 endoureterotomies, the main weakness found in this technique is that in some cases (especially longer strictures) invagination towards the lumen is very limited as the perianastomotic area is well-adhered and firm. Despite not complicating the endoureterotomy itself, this reduces safety and visibility compared to cases in which optimal invagination is achieved.
Long-term outcomes of surgical management in subtypes of Chiari malformation
Published in Neurological Research, 2021
Recep Basaran, Caglar Bozdogan, Mehmet Senol, Dogan Gundogan, Nejat Isik
In the literature, studies concerning symptom relief typically consider only about CM-1 [39,40]. More than three-quarters of the patients still considered their situation to be improved at long-term follow-up after surgery. These results support surgical intervention in symptomatic CM-1 patients [39–43]. The duration of symptoms, respiratory distress, and basilar invagination are significant predictors of outcome in CM patients. The effect of SM in predicting the clinical outcomes could not be determined, due to differences in the numbers of patients in the groups with and without SM [44]. Peripheral neuropathy, valsalva headache and paresis can be predictors for poor outcome and on the other hand surgery in the early age can be a predictor for a better outcome [45].