Search results for "emergency surgery"
showing 10 items of 31 documents
Impact of COVID-19 on hand surgery in Italy: A comparison between the Northern and the Southern regions
2021
The aims of this study were to evaluate the impact of the COVID-19 pandemic on emergency and elective hand surgery in four Italian regions that had either a high (Lombardy and Piemonte) or a low (Sicilia and Puglia) COVID-19 case load to discuss problems and to elaborate strategies to improve treatment pathways. A panel of hand surgeons from these different regions compared and discussed data from the centers they work in. The COVID-19 pandemic had an enormous impact on both elective and emergency surgery in Italy, not only in highly affected regions but also – and paradoxically even at a higher extent – in regions with a low COVID-19 case load. A durable and flexible redesign of hand surge…
Veränderungen im klinischen Bild und der chirurgischen Therapie bei Morbus Crohn Erfahrungen aus 10 Jahren
1998
Changes in clinical presentation of Crohn's disease (CD), patients' age at the time of disease manifestation and operation, general condition and duration of medical management were investigated in a retrospective study. 395 operations for CD were divided into consecutive groups and analysed. In an increasing number of cases patients presented with the "fibrostenotic type" rather than the "fistulizing type" of complaints. The duration of disease and of medical management increased. Patients in later groups were younger and in better general condition. We found a rise in frequency of patients with recurrent CD or prior abdominal surgery for other reasons. Primary surgery for CD increasingly …
Preoperative care in emergency surgery
2017
Be prepared. Sir Robert Baden-Powell Introduction Surgical emergencies in the elderly concern mainly trauma, intra-abdominal and vascular surgery. Abdominal pain constitutes 10-15% of all complaints and the unspecific nature of initial symptoms often makes accurate diagnosis difficult. Radiological imaging is often employed in aiding diagnosis and delay in performing these investigations can impact on surgical outcomes. Delays can be attributed to unstable hemodynamic conditions, delayed presentation of the illness, lack of physical signs at first presentation and inability to obtain proper history. The overall morbidity seems to be reduced when surgery is performed within the first 24-48 h…
Fully robotic Ivor–Lewis esophagectomy (RAMIE4) for esophageal cancer after emergency surgery and ligation of the gastroduodenal artery
2018
We report a case of a 69-year-old patient with esophageal cancer and severe upper gastrointestinal bleeding during neoadjuvant radiochemotherapy who required mass transfusion followed by complex emergency procedures. Despite endoscopic stenting, the bleeding recurred, and thus emergency open surgery was required. Gastric wedge resection of the minor curvature necessitated by perforation caused by the endoscopic stent maneuver and duodenotomy with ligation of the gastroduodenal artery, as the cause of persistent intraluminal bleeding, were performed. The already prepared gastric conduit during the emergency operation did not become ischemic, even though the gastroduodenal artery, left gastr…
De Garengeot Hernia: Case Report and Review of the Literature of a Rare Femoral Hernia
2021
AbstractDe Garengeot hernia is a rare femoral hernia defined as the presence of the appendix within the femoral hernia sac. The incidence of appendicitis in this type of hernia is a rare condition that accounts for 0.08–0.13% of all De Garengeot hernias. We describe the case of a 61-year-old woman that presented at the emergency department with a tender mass (diameter 10 × 8 cm) in the right groin region for 5 days associated with pain in lower right abdomen and accompanied by fever (38 °C). Computed tomography (CT) of the abdomen revealed the presence of a complex fluid collection with small foci of air in the right inguinal region, measuring 9 × 7 × 10 cm in the 3 orthogonal dimensions an…
Duodenal perforation as presentation of gastric neuroendocrine tumour: A case report
2020
Highlights • Gastric neuroendocrine neoplasms (g-NENs) represent the most frequent digestive NENs and are increasingly recognized thanks to diffusion of upper gastrointestinal endoscopy. • g-NENs can be sporadic or associated with multiple endocrine neoplasia type 1 (MEN-1) and present with a functional Zollinger-Ellison syndrome. • We described a case of a 60 years old Caucasian male came to emergency room with diffuse abdominal pain and leukocytosis on blood tests. • At the level of the pyloric portion we found irregularly thickened walls associated with a small fluid collection and bubbles of free air. On exploratory laparoscopy we found a large perforation (about 5 cm of size) in the fi…
Goals of Care in Emergency Abdominal Surgery in the Elderly and Frail Patient
2021
Elderly and frail patients are often those at highest risk during surgical procedures both in terms of intraoperative complications and postoperative outcome. It is clear that the best therapeutic result in the elderly and frail patient can be obtained through multidisciplinary management of the problem. In the management of elderly and frail patients undergoing to emergency surgery, we can make a series of considerations that guide our decision-making process. First, correct diagnosis can be difficult because of the impaired cognitive and physical status of the patient or other clinical conditions and medications that mask signs and symptoms. Second, the choice of the treatment to be carri…
Retrorectal tumour simulating vaginal birth: an exceptional case of emergency surgery indication
2017
Cystic retrorectal tumours are a very rare entity that pose a problem in differential diagnosis between congenital cyst and other lesions. We present a 49-year-old female patient presenting a perineal bulge which was discovered simulating a vaginal birth associated with prolapsed haemorrhoids grade IV. The interest of this case resides in the surgical indication of a big presacral cyst demonstrated via CT causing acute intense pain due to pelvic organ compression, as no emergent surgery management has been reported up to date.
Small bowel volvulus due to a large intestinal lipoma: A rare case report
2020
Highlights • These are rare, benign, slow-growing mesenchymal tumors originating from adipose tissue in the bowel wall. Lipomas of mesentery, mesocolon, and antimesenteric side of intestine are extremely rare. • We describe a case of small bowel obstruction secondary to volvulus due to an antimesenteric ileal lipoma. • Mesenteric lipomas are rare clinical entity, with less than 50 cases described in English language literature. CT scan is the gold standard imaging modality for diagnosis of mesenteric lipoma and other lipomatous abdominal masses. • It shows homogenous tumor of adipose tissue, gives information about features of the small bowel and if there is evidence of ischemia and can dem…
Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry
2020
Abstract Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in…