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Ogilvie Syndrome or Acute Colonic Pseudo-Obstruction
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Matthew J. Forestiere, Kenji Inaba
Surgery for Ogilvie syndrome, although once considered the standard of care, is now used as a last resort and reserved for patients with ischemia or perforation. Historically, cecostomy or tube cecostomy were the most common surgical procedures of choice in this usually frail, debilitated patient population before neostigmine or endoscopy became more prominent. These procedures had higher success rates with lower morbidity and mortality when compared to more invasive surgical procedures (Vanek and Al-Salti, 1986).
A patient with severe constipation and a behavioral disorder
Published in Onnalisa Nash, Julie M. Choueiki, Marc A. Levitt, Fecal Incontinence and Constipation in Children, 2019
Katrina Hall, Charae Keys, Rose Lucey Schroedl
This is a challenging decision with multiple factors to consider. In this patient, the medical team chose to do a laparoscopic-assisted cecostomy for a few reasons: Sometimes a thick abdominal wall can present difficulties for the surgeon where the native appendix cannot reach the umbilicus.Some patients with behavioral and developmental needs may have difficulty with the sensory aspect and compliance of catheterization of the Malone site in the umbilicus. The ability to connect to an indwelling device can be less invasive for patients and promote cooperation.
Seven-year-old boy with a history of Hirschsprung disease: Case study
Published in Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt, Pediatric Colorectal and Pelvic Surgery, 2017
Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt
A 7-year-old boy with a history of Hirschsprung disease (HD) who underwent a transanal Soave pull-through as an infant comes to see you because he has recurrent episodes of enterocolitis.At another institution, he underwent a redo of the pull-through because of a retained transition zone, but thereafter had no improvement of symptoms.A cecostomy was then performed to treat the continued obstructive symptoms, but without improvement. Finally, in desperation, an ileostomy was opened.The ileostomy was reversed, the obstructive symptoms returned, and it was reopened.You are asked to give an opinion.
Refractory ulcerative colitis stabilized by interval washed microbiota transplantation: less is more
Published in Current Medical Research and Opinion, 2022
Yun Wang, Bota Cui, Faming Zhang
A 25-year-old man was referred to the Second Affiliated Hospital of Nanjing Medical University, China, due to the refractory UC in December 2014. He was diagnosed with UC in August 2006. Taking mesalazine (3 g/d) orally showed no sustained benefits. In 2009, he started to take prednisone, which enabled him symptom-free from 2009 to 2011. The symptoms recurred after prednisone withdrawal. In June 2013, he underwent the percutaneous endoscopic cecostomy (PEC) and a PEC tube was inserted at the proximal end of ascending colon in another hospital. He was treated with mesalazine through a PEC tube for six months. But no improvement was observed. In December 2013, he started to undergo manual FMT daily through a PEC tube at home. The stool was donated by his father who did not undergo any donor screening. They processed the crude fecal microbiota preparation by themselves at home. He underwent 60 FMTs in two months and achieved clinical remission for eight months (Figure 1).
Burden of Crohn’s disease in the United States: long-term healthcare and work-loss related costs
Published in Journal of Medical Economics, 2020
Ameur M. Manceur, Zhijie Ding, Erik Muser, Camilo Obando, Jennifer Voelker, Dominic Pilon, Frederic Kinkead, Marie-Hélène Lafeuille, Patrick Lefebvre
Subgroups of patients with CD were defined based on the following patterns, which occurred during the observation period of the main analysis: (a) CD-related surgery (i.e. a surgery typically associated with IBD [intestinal resection, colostomy, cecostomy, endoscopic balloon dilation, stricturoplasty] after the first diagnosis for CD), (b) ≥1 episode of ≥3 months of continuous use of opioids, (c) ≥1 episode of ≥3 months of continuous use of steroids, (d) use of biologics, (e) moderate-to-severe disease (defined as use of biologics, use of immunomodulators, ≥1 episode of ≥3 months of continuous use of steroids, or ≥1 CD-related hospitalization, including surgery for CD)21,22, and (f) comorbidities frequently associated with CD, such as anemia and anxiety or depression to include both a physical and a mental comorbidity10,23.
Exploring the ICF-CY as a framework to inform transition programs from pediatric to adult healthcare
Published in Developmental Neurorehabilitation, 2018
Laura R. Hartman, Amy C. McPherson, Joanne Maxwell, Sally Lindsay
Although such bodily structure and function-related experiences impact life beyond the transition to adulthood, they must be considered anew in light of the additional responsibility of self-managing such routines that arises with the increased independence that is expected with a transition into adult roles. Self-management of bowel and bladder routines related to a larger area of discussion in the literature, which was maintaining one’s health (code d5702 discussed below). Maintaining one’s health involved not only the ability to independently manage one’s health and daily care needs, but was further extended to include direction of care, such as accessing appropriate services or personnel to attend to needs as they arise. Transitioning into the adult healthcare system required youth, young adults, and families to take on the roles of managing and directing their own care. Specifically relating to bowel and bladder care, increased self-management and care direction included learning to coordinate services and appointments for cecostomy tube checks, help with toileting and bladder routines, ensuring that they have a supply of catheters, or seeking medical attention when they note infections or other issues related to bowel and bladder routines.