Successful Closure of a Persistent Enterocutaneous Fistula with a Myocutaneous Flap.

Enterocutaneous fistulas can present with significant morbidity and mortality for affected patients, as the abnormal connection can result in exorbitant loss of enteral fluids, electrolyte disturbances, and sepsis, among other complications. We present a patient with a chronic complex enterocutaneous fistula who underwent several surgeries, resulting in a considerable amount of bowel resection. Based on history and findings of high output fistula with diverting transverse colostomy, the fistula was closed with a left rectus myocutaneous pedicle flap to avoid entering the abdominal cavity and prevent the possibility of short bowel syndrome.

Effect of Clot Stiffness on Recombinant Tissue Plasminogen Activator Lytic Susceptibility in Vitro.

The lytic recombinant tissue plasminogen activator (rt-PA) is the only drug approved by the Food and Drug Administration for treating ischemic stroke. Less than 40% of patients with large vessel occlusions who are treated with rt-PA have improved blood flow. However, up to 6% of all patients receiving rt-PA develop intracerebral hemorrhage.