Background: Gastrointestinal fistulization (GIF) is a rare and potentially fatal complication of acute necrotizing pancreatitis (ANP). There is paucity of data on clinical course and outcome of GIF in walled of necrosis (WON).
Objective: To evaluate frequency, clinical as well as imaging findings and outcome of spontaneous symptomatic GIF in patients with WON.
Methods: Retrospective analysis of database of patients with asymptomatic WON on regular follow-up over last six years to identify patients with symptomatic GIF.
Results: Out of 138 patients with asymptomatic WON seen during the study period, 16 (11.5%) patients (all males; mean age 41.7 ± 9.9 years) developed symptomatic GIF. The mean size of WON in patients who developed GIF was 9.5 ± 2.4 cm, and fistulization occurred after 65.1 ± 17.8 days of the onset of ANP. The site of fistulization was stomach, duodenum, jejunum, colon, and esophagus in seven (43.7%), five (31.2%), one (6.2%), two (12.5%), and one (6.2%) patients, respectively. GIF resulted in spontaneous resolution in two patients (stomach 1 and esophagus 1). The remaining patients with gastric (six patients) and duodenal (five patients) fistulization were successfully treated endoscopically by placing multiple plastic stents in the necrotic cavity after balloon dilatation of the fistulous tract. Patients with colonic fistulization required surgery. None of the patients succumbed to the illness.
Conclusion: Symptomatic GIF of WON usually occurs within the first three months of onset of ANP. It commonly occurs in either stomach or duodenum and can be successfully managed endoscopically.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10620-021-06900-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Ligation of the intersphincteric fistula tract (LIFT) for high transsphincteric fistulas: a double-center retrospective study with long-term follow-up.
Ann Coloproctol
January 2025
Department of Colorectal Surgery, Graduate School of Jiangxi University of Chinese Medicine, Nanchang, China.
Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas.
Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least 1/3 of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023.
[Unmet health care needs of younger and older people with intellectual, mental and multiple disabilities: A pilot study in a facility in the Ruhr area].
Z Evid Fortbild Qual Gesundhwes
January 2025
Institut für Medizinmanagement und Gesundheitswissenschaften (IMG) der Universität Bayreuth, Bayreuth, Deutschland.
Introduction: Unmet health care needs are seen as a key indicator of equity in access to health care. With younger people, they can lead to poorer health outcomes in adulthood, and in older people they can be associated with an increased risk of mortality. The presence of a disability is considered a risk factor for unmet needs.
View Article and Find Full Text PDFA scoping review of interventions to optimize medication adherence in hypertension comorbidity.
Res Social Adm Pharm
January 2025
Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Ghana. Electronic address:
Background: Patients with hypertension and other comorbidities have difficulties adhering to their medications which have negative impacts on clinical outcomes. Although some studies have identified strategies to improve medication adherence, a thorough analysis of these interventions will provide synthesized evidence for clinical decision-making and improved health outcomes for patients with hypertension comorbidities.
Aim: To conduct a scoping review on interventions that have been utilised to improve medication adherence in patients with hypertension and other co-morbid conditions.
A conceptual framework for identifying and managing system vulnerabilities for diversion of controlled substances in healthcare.
Res Social Adm Pharm
January 2025
Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada; Research & Innovation, North York General Hospital, 4001 Leslie Street, Toronto, Ontario, M2K 1E1, Canada.
Purpose: Diversion or theft of controlled substances is a recognized problem affecting healthcare systems globally. The purpose of this study was to develop a framework for identifying and characterizing system factors leading to vulnerabilities for diversion within hospitals.
Methods: We applied a qualitative framework method, which involved 1) compiling a list of critical diversion vulnerabilities through observations and proactive risk analyses in the inpatient pharmacy, emergency department and intensive care unit of two Canadian hospitals; 2) coding the vulnerabilities into deductively and inductively derived themes and subthemes; and 3) building a conceptual framework.
A collaborative interdisciplinary approach for trigger finger management.
J Hand Ther
January 2025
Venture Rehabilitation Sciences Group, Saskatoon, SK, Canada; School of Rehabilitation Science, University of Saskatchewan, Saskatoon, SK, Canada. Electronic address:
Background: Stenosing tenosynovitis, or trigger finger, is a common cause of hand disability. This study outlines a trigger finger management protocol that redirects referrals for surgical consultations to conservative management first.
Purpose: The primary outcome variable was the protocol endpoint based on the resolution of trigger finger symptoms (i.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!