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Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.
View Article and Find Full Text PDFGastric Parastomal Hernia: A Case Report of a Rare yet Fascinating Clinical Entity.
Cureus
June 2019
General Surgery, Central Michigan University College of Medicine, Saginaw, USA.
Article Synopsis
- A 58-year-old woman with diabetes experienced nausea, malaise, and abdominal pain, and was found to have a parastomal hernia, likely from her history of a colostomy due to a previous rectal infection.
- A CT scan showed gastric contents in the hernia sac, causing gastric obstruction, which was treated conservatively with nasogastric suction and IV fluids.
- The patient improved with conservative management and plans to have surgery later, marking this as a rare case of a parastomal hernia successfully managed without immediate surgery.
Enhanced recovery after anterior resection: earlier leak diagnosis and low mortality in a case series.
Ann R Coll Surg Engl
September 2019
Department of Colorectal Surgery, Salisbury District Hospital, Salisbury, UK.
Introduction: Early detection and treatment of anastomotic leak may mitigate its consequences. Within an enhanced recovery setting, the subtle signs of a leak can be more apparent. There are multiple treatment options for anastomotic leak following anterior resection.
View Article and Find Full Text PDFOgilvie's syndrome treated with an emergency laparotomy, right hemicolectomy and end ileostomy.
BMJ Case Rep
October 2017
The Royal Stoke University Hospital, Stoke-on-Trent, UK.
Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is a rare clinical entity in which there is massive non-toxic colonic dilatation in the absence of a mechanically obstructing lesion. It is an important yet poorly recognised cause of surgical morbidity and mortality occurring typically in elderly patients with multiple comorbidities. ACPO can often be reversed conservatively with colonoscopic or nasogastric decompression.
View Article and Find Full Text PDFThe role of single-shot metronidazole in the prevention of Clostridium difficile infection following ileostomy reversal surgery.
Int J Colorectal Dis
May 2017
Department of Surgery & Cancer, Queen Alexandra Hospital, Southwick Hill Rd, Portsmouth, PO6 3LY, UK.
Purpose: Symptomatic infection with Clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. In February 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, in a bid to reduce rates of Clostridium difficile infection.
Methods: A retrospective cohort study was conducted at a single, large hospital trust between February 2014 and February 2016, before and after change in antimicrobial policy.
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