0000000000071128
AUTHOR
D'orazio B.
Rectal Diclofenac administration for prevention of post-Endoscopic Retrograde Cholangio-Pancreatography (ERCP) acute pancreatitis. Randomized prospective study.
Introduction. Post-Endoscopic Retrograde Cholangio-Pancreatography pancreatitis (PEP) is a relevant (1-4%) complication of biliopancreatic operative endoscopy. Rectal nonsteroidal anti-inflammatory drugs (specifically, 100 mg of diclofenac) have shown promising prophylactic activity in PEP. The aim of our prospective study is to report whether prophylactic oral versus rectal suppository versus intramuscular diclofenac versus placebo are able to reduce the incidence and the severity of ERCP-induced pancreatitis.Materials and Methods. in this randomized, double-blinded, prospective study, 100 patients (49 male, 51 female), similar with regard to indication for ERCP, were enrolled between Janu…
A rare clinical entity: stump appendicitis. Case report and complete review of literature.
BACKGROUND: Stump appendicitis is a rare delayed complication post-appendectomy and it represents a diagnostic problem as clinicians are often not very familiar with this pathology. MATERIALS AND METHODS: One case of stump appendicitis has been reported in a 54 year old woman, whose acute phase was conservatively treated in our Department. A review of Medline literature was also carried out, from 1945 to 2015, showing 111 cases of stump appendicitis. RESULTS: Stump appendicitis has been reported after either open or laparoscopic appendectomy, in a range between days to several years from the first procedure. Nowadays, it is not considered yet as a possible differential diagnosis in patients…
Premedication with oral solution of simethicone plus N-acetylcysteine to improve the quality upper GI endoscopy: Initial experience
Introduction: To assess the efficacy and safety of simethicone with or without N-acetylcysteine (NAC) as premedications before gastroscopy. Materials and methods: Patients were randomized into 5 groups. Endoscopic visibility was evaluated in 4 districts (esophagus, gastric body, fundus and antrum) using a visual scale, graduating from 1 to 4 points. Results: There was no significant difference on the rate of positive findings when comparing simethicone with simethicone plus NAC and with water, respectively. Simethicone plus NAC showed better total mucosal visibility score than simethicone alone. Both simethicone plus NAC and simethicone alone offer more benefit than water. The procedure tim…
Spontaneous rupture of umbilical hernia in end stage liver disease patient: injection of fibrin glue as a temporary solution.
Background. Umbilical hernia is a common disease, which occurs in 20% of cirrhotic patients in the presence of persistent ascites. A rare but dangerous complication of this disease in end stage liver patient is a spontaneous rupture of umbilical hernia with ascitic fluid leaking. Up to date there is no general consensus on its most appropriate treatment. Case report. A 60 years-old male patient, with Child Pugh C and Meld score of 18 end stage liver disease, came to our observation for a spontaneous minimal rupture of his long lasting 5 cm umbilical hernia with ascitic fluid leaking. A medical therapy was undertaken aiming to manage the ascites and a temporary conservative therapy, with fib…