Small bowel anastomosis in emergency surgery.

Background: Emergency laparotomy is associated with a high morbidity and mortality rate. The decision on whether to perform an anastomosis or an enterostomy in emergency small bowel resection is guided by surgeon preference alone, and not evidence based. We examined the risks involved in small bowel resection and anastomosis in emergency surgery.

Determining a multidisciplinary intraoperative strategy in emergency surgery for bowel obstruction and its impact on outcomes.

Purpose: Bowel obstruction accounts for around 50% of all emergency laparotomies. A multidisciplinary (MDT) standardized intraoperative model was applied (definitive, palliative, or damage control surgery) to identify patients suitable for a one-step, definitive surgical procedure favoring anastomosis over stoma, when undergoing surgery for bowel obstruction. The objective was to present mortality according to the strategy applied and to compare the rate of laparoscopic interventions and stoma creations to a historic cohort in surgery for bowel obstruction.

Inter-hospital variation in management of patients with small bowel obstruction in Denmark.

Introduction: Inter-hospital variation in the management of small bowel obstruction (SBO) has been described in other countries, but the extent to which similar variations exist in Denmark remains unknown. This study aimed to compare the management of SBO between hospitals in Denmark and identify potential areas for improvement METHODS. This was a multicentre prospective study performed at six emergency hospitals.

Small bowel anastomosis in peritonitis compared to enterostomy formation: a systematic review.

Purpose: Anastomotic leakage after small bowel resection in emergency laparotomy is a severe complication. A consensus on the risk factors for anastomotic leakage has not been established, and it is still unclear if peritonitis is a risk factor. This systematic review aimed to evaluate if an entero-entero/entero-colonic anastomosis is safe in patients with peritonitis undergoing abdominal acute care surgery.

[Acute cholangitis due to metal clips in the ductus choledochus after laparoscopic cholecystectomy].

Acute cholangitis caused by migrating clips is a possible complication following laparoscopic cholecystectomy. In this case report, a 50-year-old woman was admitted to the hospital with fever, icterus, and epigastric pain. Blood samples and blood cultures showed cholestasis, signs of infection and three different types of bacteria in the blood stream.

Perioperative clinical management in relation to emergency surgery for perforated peptic ulcer: A nationwide questionnaire survey.

Background & Aims: Perforation is a severe complication of peptic ulcer disease. Evidence regarding perioperative management of patients undergoing surgery for perforated peptic ulcer is scarce without any clear guidelines. This study aimed to investigate the clinical practice and possible differences in the perioperative management of patients undergoing emergency surgery for perforated peptic ulcers in Denmark.

Early laparoscopic cholecystectomy for acute cholecystitis is safe regardless of timing.

Purpose: The optimal timing for laparoscopic cholecystectomy for acute cholecystitis (AC) has not been resolved. In the revised Tokyo Guidelines from 2018 (TG18), early laparoscopic cholecystectomy (ELC) is recommended regardless of the duration of symptoms. The aim of this study was to evaluate the safety of ELC compared with delayed laparoscopic cholecystectomy (DLC) for AC.

[Mortality rate after acute laparotomy can be reduced].

Acute abdomen is a common cause of admission to hospital. Emergency laparotomy is associated with a significant morbidity and mortality due to deranged physiology and surgery-induced stress. Damage control laparotomy is on the rise as an operative strategy for the septic abdomen as well as for trauma laparotomy but lacks definition in the non-trauma setting.

[Gastric necrosis four years after fundoplication causing a dead foetus].

A 31-year-old pregnant woman was admitted and treated for diabetic ketoacidosis. As the patient deteriorated and the viability of the foetus was uncertain a CT scan was done which showed free fluid and air intraabdominally. Surgery was performed.

Capsule endoscopy: a cause of late small bowel obstruction and perforation.

Case Report. A 71-year-old man was admitted to the department of gastroenterology with diffuse abdominal pain. Through the previous 12 months, the patient had experienced episodes of vomiting and watery diarrhea of increasing intensity as well as weight loss.

[Necrotizing fasciitis].

Introduction: Necrotizing fasciitis (NF) is an acute soft-tissue infection, associated with a high mortality and morbidity. To reduce the mortality, an early diagnosis and treatment is essential. Our study aims to identify the number of patients, the microorganisms involved, and NF treatment outcomes among patients admitted to our unit.