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Transomental hernia resulting in a closed loop small bowel obstruction: delayed presentation following paediatric blunt abdominal trauma.
BMJ Case Rep
January 2025
General Surgery, Toowoomba Hospital, Toowoomba, Queensland, Australia.
While internal hernias are rare in the paediatric population, it should be considered as a cause for an acute abdomen following blunt trauma. Internal hernias represent a surgical emergency that requires prompt recognition due to the high risk of strangulation and ischaemia of affected bowel loops. The case of a transomental hernia (TOH) is described in a young girl.
View Article and Find Full Text PDFNon-Occlusive Mesenteric Ischemia in Aortic Surgery: What You Need to Know.
Ann Vasc Surg
January 2025
Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India.
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.
View Article and Find Full Text PDFEffects of Aneurysmal Subarachnoid Hemorrhage in Patients Without In-Hospital Infection on FABP-I, LBP, and sCD-14.
Int J Mol Sci
January 2025
Department of Neurosurgery, Medical School, University of Pecs, 7622 Pecs, Hungary.
Aneurysmal subarachnoid hemorrhage (aSAH) is a serious condition complicated by delayed cerebral ischemia (DCI), where inflammation plays a key role. Although altered gut permeability is noted in other conditions, its significance in aSAH remains unclear. Fatty acid-binding protein (FABP-I), lipopolysaccharide-binding protein (LBP), and soluble CD-14 (sCD-14) are established markers of barrier dysfunction.
View Article and Find Full Text PDFContinuous renal replacement therapy with cytokine-adsorbing hemofilter to control resuscitative endovascular balloon occlusion of the aorta-related ischemia-reperfusion injury in a swine hemorrhagic shock model.
Eur J Trauma Emerg Surg
January 2025
Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chiba, 260-8677, Japan.
Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is beneficial for uncontrollable torso bleeding; however, prolonged REBOA causes ischemia-reperfusion injury. The purpose of this study is to examine the hypothesis that continuous renal replacement therapy (CRRT) with a cytokine-adsorbing hemofilter would improve mortality due to hemorrhagic shock with REBOA-reperfusion injury by controlling metabolic acidosis, hyperkalemia, and hypercytokinemia.
Methods: Hemorrhagic shock with 40% blood loss was induced by phlebotomy in eight female swine.
External validation of a CT score for predicting ischaemia in adhesive small-bowel obstruction.
Eur Radiol
January 2025
Department of Diagnostic and Interventional Radiology, François-Mitterrand University Hospital, Dijon, France.
Objectives: To assess the diagnostic accuracy, in a validation cohort, of a score based on three CT items, which has shown good performance for predicting ischaemia complicating acute adhesive small-bowel obstruction (SBO).
Methods: This retrospective single-centre study of diagnostic accuracy included consecutive patients admitted for acute adhesive SBO in 2015-2022, who were treated conservatively or underwent surgery within 24 h after CT. The gold standard for ischaemia was an intraoperative diagnosis for operated patients, while the absence of ischaemia was confirmed either by its absence during surgery or by clinical follow-up in patients who did not undergo surgery.
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