The three-step method for ultrasound-guided pediatric internal jugular venous catheterization: a clinical trial.

Ultrasound guidance may be a valuable adjunct for pediatric internal jugular vein catheterization. We previously reported a long-axis in plane technique, called the "three-step method", resulting in high success and a low complication rate by novice operators in adult patients. This is the first report of ultrasound-guided internal jugular vein catheterization (US-IJV) using the three-step method in pediatric patients.

Successful management of a colo-duodenal fistula in a patient with Crohn's disease using a double lumen gastro-jejunostomy tube.

A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy.

Predicting the need for massive transfusion in trauma patients: the Traumatic Bleeding Severity Score.

Background: The ability to easily predict the need for massive transfusion may improve the process of care, allowing early mobilization of resources. There are currently no clear criteria to activate massive transfusion in severely injured trauma patients. The aims of this study were to create a scoring system to predict the need for massive transfusion and then to validate this scoring system.

Prolapse of the small intestine from the uterine perforation at dilatation and curettage.

Dilatation and curettage (D&C) sometimes causes uterine perforation, which usually does not cause a serious problem. Here, we report uterine perforation caused by D&C, in which the small intestine prolapsed from the uterus, requiring intestinal resection. D&C was performed for missed abortion at 9 weeks.

Elevation of intra-abdominal pressure by pneumoperitoneum decreases pancreatic perfusion in an in vivo porcine model.

Background: The goal of this study is to examine changes in pancreatic perfusion due to pneumoperitoneum using perfusion CT in vivo.

Methods: Three pigs were studied. Under general anesthesia, pneumoperitoneum was induced to 16 mm Hg.

Adenocarcinoma arising from an anal gland-Report of a case.

Introduction: Adenocarcinoma arising from an anal gland is extremely rare. Most anal canal cancers are squamous cell carcinoma, and adenocarcinoma is infrequently diagnosed. Diagnostic criteria and the standard treatment for adenocarcinoma of the anal canal have not been clearly defined, in part because of the rarity of this lesion.

Embolization of a fractured central venous catheter placed using the internal jugular approach.

Introduction: Fracture and embolization of central venous catheters placed via the subclavian approach is well recognized, but fractured catheters placed via the internal jugular vein are extremely rare.

Presentation Of Case: A 65-year-old man presented with a catheter embolus after placement of a central venous port using the internal jugular approach undertaken to administer adjuvant chemotherapy for colon cancer with lung metastases. Goose neck and conformational loop snares were successfully used to percutaneously retrieve the severed catheter, which had migrated to the right ventricle.

Endoscopic ultrasound with double-balloon endoscopy in the evaluation of small-bowel disease.

Background: Double-balloon endoscopy (DBE) has become a new standard in enteroscopy. However, it may be difficult to make a diagnosis or plan treatment strategy with endoscopic visualization alone. The addition of endoscopic ultrasonography (EUS) has the potential to improve the ability to establish the diagnosis and develop a treatment strategy.

Serum ghrelin levels partially recover with the recovery of appetite and food intake after total gastrectomy.

Purpose: Ghrelin may lead to weight gain by appetite stimulation. This prospective study investigated the association between weight loss and the ghrelin levels in patients after gastrectomy.

Methods: Thirty-three males and eight females were enrolled in the study.

Internal hernia caused by epiploic appendices successfully treated by single-incision laparoscopic surgery (SILS).

Internal hernia is a rare and often overlooked cause of small bowel obstruction. We report a case of internal hernia with an orifice composed of epiploic fat, successfully diagnosed and treated by single-incision laparoscopic surgery. This is the second report of this type of internal hernia and the first reported case addressed laparoscopically.

Lower heart rate in the early postoperative period does not correlate with long-term outcomes after repair of type A acute aortic dissection.

Little evidence exists regarding the need for a reduction in postoperative heart rate after repair of type A acute aortic dissection. This single-center retrospective study was conducted to determine if lower heart rate during the early postoperative phase is associated with improved long-term outcomes after surgery for patients with type A acute aortic dissection. We reviewed 434 patients who underwent aortic repair between 1990 and 2011.

Comparison of preoperative chemotherapy using docetaxel, cisplatin and fluorouracil with cisplatin and fluorouracil in patients with advanced carcinoma of the thoracic esophagus.

We retrospectively compared preoperative docetaxel, cisplatin, and fluorouracil (DCF) with cisplatin and fluorouracil (CF) in patients with esophageal cancer. The study included patients with advanced thoracic esophageal carcinoma (excluding T4 tumors) receiving preoperative chemotherapy. In the DCF group, five patients received two courses of treatment every 4 weeks, and 33 patients received three courses every 3 weeks.

Superior mesenteric venous thrombosis after laparoscopic exploration for small bowel obstruction.

Mesenteric venous thrombosis is a rare cause of intestinal ischemia which is potentially life-threatening because it can lead to intestinal infarction. Mesenteric venous thrombosis rarely develops after abdominal surgery and is usually associated with coagulation disorders. Associated symptoms are generally subtle or nonspecific, often resulting in delayed diagnosis.

Optimal timeline for emergency surgery in patients with strangulated groin hernias.

Purpose: This retrospective study evaluates the clinical course and outcomes of patients who underwent surgery for strangulated hernias.

Methods: Among 520 groin hernias from 2001 to 2012, 51 inguinal and 42 femoral hernias were strangulated and operated emergently at a tertiary referral center. Perioperative factors, patient profiles, and time interval to surgery (T total = time from onset to surgery, T 1 = time from onset to initial evaluation, T 2 = time from the first hospital to the tertiary center, T 3 = time from admission at the tertiary center to surgery, T total = T 1 + T 2 + T 3) were analyzed in patients with strangulation, then compared between two groups, the bowel resection (BR) group and the non-bowel resection (NBR) group.

Analysis of hand motion differentiates expert and novice surgeons.

Background: The number of operations performed by a surgeon may be an indicator of surgical skill. The hand motions made by a surgeon also reflect skill and level of expertise. We hypothesized that the hand motions of expert and novice surgeons differ significantly, regardless of whether they are familiar with specific tasks during an operation.

Primary hepatic choriocarcinoma in a 49-year-old man: report of a case.

We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical course. The patient was a 49-year-old man who presented with acute right-sided abdominal pain. There were no masses palpable on physical examination.

Extraduodenal papillectomy: a feasible alternative method of total papillectomy.

Rational treatment for neoplasms of the duodenal papilla (NDPs) is still controversial, especially for early stage lesions. Total papillectomies are indicated in patients expected to have adenomas, adenocarcinoma in an adenoma, or mucosal adenocarcinomas with no lymph node metastases. However, the preoperative pathological evaluation of NDPs is still challenging and often inaccurate, mainly because of the complicated anatomical structures involved and the possibility of an adenocarcinoma in an adenoma.

Retroperitoneal abscess associated with a perforated duodenal ulcer.

Retroperitoneal abscess after duodenal ulcer perforation is a rare condition. A 71-year-old woman was admitted with 1 month of appetite loss and back pain. Abdominal computed tomography scan showed a retroperitoneal mass behind the third and fourth portions of the duodenum.

Sigmoid volvulus after laparoscopic surgery for sigmoid colon cancer.

We report the first case of sigmoid volvulus after laparoscopic surgery for sigmoid colon cancer. The patient is a 75-year-old man who presented with the sudden onset of severe abdominal pain. He had undergone laparoscopic sigmoidectomy for cancer 2 years before presentation.

Primary and secondary adenocarcinomas associated with anal fistulae.

Purpose: The purpose of this study was to evaluate the clinical features, pathology, and etiology of adenocarcinoma in patients with anal fistulae.

Methods: We identified seven patients diagnosed with adenocarcinoma associated with anal fistulae from a retrospective chart review.

Results: Five patients were diagnosed with primary adenocarcinoma associated with anal fistulae.

Imaging and pathological characteristics of small acinar cell carcinomas of the pancreas: A report of 3 cases.

We present three patients with T2 acinar cell carcinomas (ACC) (two of which were small) and discuss their clinical and pathological features. Case 1: A 34 year-old woman had a 2.6 cm iso- or hyperdense tumor.

Partial duplication of MSH2 spanning exons 7 through 14 in Lynch syndrome.

Background: Lynch syndrome, also referred to as hereditary nonpolyposis colorectal cancer, is the most common form of hereditary colorectal cancer, and is associated with a high incidence of multiple primary neoplasms in various organs.

Methods: A 79-year-old woman (patient 1) diagnosed with ascending colon cancer had a history of previous carcinomas of the uterus, stomach, uroepithelial tract, and colon. One year later, she developed a brain tumor (glioblastoma).