We report a case of a 60 years old man admitted for infected acute pancreatitis and duodenal fistula with mediastinal extension at admission, successfully treated in a 40-days period with CT-guided percutaneous catheter drainage (Malecot 14F) inserted with Seldinger method, in spite of a colic fistula development during the treatment.
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Int J Colorectal Dis
January 2025
Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy.
Purpose: Acute appendicitis (AA) is the leading cause of acute abdomen worldwide, with an incidence of 90-100 cases per 100,000 individuals annually and a lifetime risk of 7-12%. Despite its prevalence, historical accounts of AA are limited, particularly when compared to conditions like haemorrhoids, likely due to the appendix's internal location. This article traces the historical evolution of AA treatment from ancient times to the present, highlighting key contributions.
View Article and Find Full Text PDFEur Radiol
January 2025
Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Objectives: To compare the diagnostic accuracy of ULDCT to CXR for detecting non-traumatic pulmonary diseases at the emergency department (ED) and to study diagnostic confidence levels.
Methods: Secondary analysis of the prospective OPTIMACT trial (2418 ED participants randomly allocated to ULDCT or CXR). Diagnoses at imaging at the ED were compared to the reference diagnosis on day 28.
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA.
Vasoplegia is a pathophysiologic state of hypotension in the setting of normal or high cardiac output and low systemic vascular resistance despite euvolemia and high-dose vasoconstrictors. Vasoplegia in heart, lung, or liver transplantation is of particular interest because it is common (approximately 29%, 28%, and 11%, respectively), is associated with adverse outcomes, and because the agents used to treat vasoplegia can affect immunosuppressive and other drug metabolism. This narrative review discusses the pathophysiology, risk factors, and treatment of vasoplegia in patients undergoing heart, lung, and liver transplantation.
View Article and Find Full Text PDFKeio J Med
January 2025
I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
We describe a case of sarcoidosis in a previously healthy 39-year-old man with the development of an acute kidney injury, requiring renal replacement therapy, as the first manifestation of the disease. The course of the disease was complicated by a сatheter-associated bloodstream infection. According to the histological examination of kidney biopsy samples, granulomatous interstitial nephritis was diagnosed.
View Article and Find Full Text PDFGastroenterol Clin North Am
March 2025
Gastroenterology Department, Dr. Balmis General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), Servicio de Aparato Digestivo, 4 planta C, Pintor Baeza 12, 03010, Alicante, Spain; Clinical Medicine Department, Miguel Hernandez University, Campus UMH de Sant Joan, Edificio Francisco Javier Balmis, Carretera Nacional 332 s/n, 03550, San Juan de Alicante, Spain. Electronic address:
The initial management of acute pancreatitis (AP) is continually evolving. Goal-directed moderate fluid resuscitation is now preferred over more aggressive strategies. Antibiotics should be administered only when there is a proven or highly probable infection rather than for prophylactic purposes.
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