Basrah Journal of Surgery最新文献_第9页

BLEEDING FOLLOWING BARIATRIC SURGERY (TYPES & MANAGEMENT MODALITIES) 减肥手术后出血(类型和处理方式)

Basrah Journal of Surgery Pub Date : 2018-12-28 DOI: 10.33762/BSURG.2018.160089

F. Al-Gazgooz, Abdulkareem Jabbar Ghadban Al-Ebadi

{"title":"BLEEDING FOLLOWING BARIATRIC SURGERY (TYPES & MANAGEMENT MODALITIES)","authors":"F. Al-Gazgooz, Abdulkareem Jabbar Ghadban Al-Ebadi","doi":"10.33762/BSURG.2018.160089","DOIUrl":"https://doi.org/10.33762/BSURG.2018.160089","url":null,"abstract":"Bleeding is a serious complication following bariatric procedures such as Minigastric bypass (MGB), Roux-En-Y Gastric Bypass (RYGB) Surgery, and Sleeve Gastrectomy (SG). Post bariatric bleeding is either acute or chronic. Although this complication is declined now, but still it is important to know because if it is not managed urgently it will lead to serious results. The source of bleeding may be from the staple lines, unexpected injury to the spleen, or to one of the blood vessels around the surgical field. The other source of bleeding may be internal through the GIT and it is presented as hematemesis or melena. Gastrointestinal bleeding in patients underwent bariatric surgery may occur in the esophagus, gastric pouch, new sleeved stomach, the Roux limb just distal to the anastomosis, the remaining of the small intestine. The site of bleeding can be determined and treated mostly by endoscopy but in certain cases may require re-laparoscopy. The aim of this study is to analyze the incidence, types and management of this bleeding. This is a prospective study which has been done in Al-Sadr Teaching Hospital, Basrah, Iraq, from June 2015 to June 2017. The study included 540 case who were subjected to SG, RYGB, MGB and they were analyzed regarding; time of occurrence, postoperative bleeding, types whether intra-peritoneal or intra-luminal and type of approaches for treating this bleeding. In our study we don’t over sewn the staple line and didn't use any buttressing material or synthetic coagulation powder. The total number of patients developed post-operative bleeding were 18 cases out of 540, 12 after sleeve gastrectomy, 3 after mini gastric bypass and 3 after Roux-En-Y. Regarding sleeve gastrectomy; two patients of the required re-laparoscopy and evacuation of hematoma with treating site of bleeding by clipping or suturing according to the condition, three patients required aspiration under ultrasound guide, while the remaining 7 cases were kept only under conservative measures. The 3 patient of the MGB were managed conservatively and the 3 cases of Roux-En-Y were managed either conservatively in 2 cases or by endoscopic intervention in one case. In conclusion, we advise the surgeons to use reinforcement of staple line to decrease incidence of post-operative bleeding. Introduction besity is a major health problem worldwide that leads to increased incidence of morbidity and mortality. People are generally regarded obese when their body mass index (BMI) exceeded 30 kg/m, and above the 25kg/m were regarded as overweight. Obesity is a risk factor of many diseases like cardiovascular diseases, diabetes, sleep apnea, osteoarthritis, depression, and rarely cancer. Life style modification such as change in diet quality and exercise can control obesity. If diet modification, exercise, and medication failed to control morbid obesity, a gastric balloon or surgery should be considered to solve the problem. The choice of procedure depends on BMI, food habit, c","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43540779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

MANAGEMENT OF SPINAL DURAL ARTERIOVENOUS FISTULA, A REVIEW WITH ONE CASE REPORT 硬脊膜动静脉瘘的治疗附1例报告

Basrah Journal of Surgery Pub Date : 2018-06-01 DOI: 10.33762/bsurg.2018.160114

M. A, H. A, Adnan Mrad A, Taghrid Chaaban A

{"title":"MANAGEMENT OF SPINAL DURAL ARTERIOVENOUS FISTULA, A REVIEW WITH ONE CASE REPORT","authors":"M. A, H. A, Adnan Mrad A, Taghrid Chaaban A","doi":"10.33762/bsurg.2018.160114","DOIUrl":"https://doi.org/10.33762/bsurg.2018.160114","url":null,"abstract":"Spinal dural arteriovenous fistulas (SDAVFs) are rare acquired vascular malformations of the spinal cord which if not treated properly, can lead to inevitable severe morbidity with progressive spinal cord symptoms. The management is still at high interest among specialists. If microsurgical treatment is still considered as a treatment of choice for SDAVFs, endovascular treatment is increasingly growing in interest with the development of endovascular techniques and new embolization materials. In this article, a short discussion is made about the spinal dural arteriovenous fistulae in respect to anatomy, etiology, diagnosis and treatment. Careful patient selection, a multidisciplinary approach and standardized surgical techniques can lead to excellent results with virtually no complications. Introduction ascular malformation of the spinal cord represents rare clinical condition characterized by a difficult diagnosis and complex management. Spinal dural arteriovenous fistulas (SDAVF) are the most common condition in these pathological entities with important clinical implications. These direct communications between radicular artery and medullary vein usually results in myelopathy due to venous hypertension. Assessment of a SDAVF is often difficult because of non-specific findings on non-invasive imaging modalities. With the advances in neuroimaging, micro neurosurgery and neuro endovascular techniques, the complete treatment of these pathological situations is very feasible with the possibility of complete remission of clinical symptomatology. Endovascular embolization was reported as an effective therapy in the treatment of SDAVFs that can be used as singular and definitive intervention in some particular cases. We present a particular case with SDAVF treated by endovascular embolization and discuss the treatment possibilities to more fully understand the optimal management of these lesions. Vascular Anatomy: Spinal cord vascularization is provided by the anterior spinal artery (ASA) and the paired posterior spinal arteries (PSA). The ASA consists of the junction of two branches originating from the two vertebral arteries proximal to the vertebra basilar junction. On its path, it receives contributions from branches of vertebral and ascending cervical arteries in the cervical region as well as from intercostal and lumbar arteries at the corresponding levels. The spinal meningeal arteries are branches of the segmental arteries founded at almost every spinal level supplying the dura in the spinal canal. Unlike these, spinal medullary arteries, which exist only at some levels, are implicated in spinal cord vascular perfusion. The artery of Adamkiewicz (great anterior spinal V Bas J Surg, June, 24, 2018 63 Management of spinal dural arteriovenous fistula M El Husseini, H Mouawia, A Mrad & T Chaaban Bas J Surg, June, 24, 2018 64 medullary artery) is the dominant thoracolumbar segmental artery with variable origin from T8 to L1 vertebral segments that ","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69678359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EVALUATION OF HEARING IN PATIENTS WITH BETA THALASSEMIA MAJOR 重度地中海贫血患者的听力评价

Basrah Journal of Surgery Pub Date : 2018-06-01 DOI: 10.33762/bsurg.2018.160106

A. A, Husam Haider Salman A, Jaafar Muhsen Khalaf A

引用次数: 0

OPEN REDUCTION AND INTERNAL FIXATION WITH CORTICOCANCELLOUS BONE GRAFT FOR TREATMENT OF VOLARY MALUNITED FRACTURE OF DISTAL RADIUS 骨皮质松质骨移植切开复位内固定治疗桡骨远端掌骨不愈合骨折

Basrah Journal of Surgery Pub Date : 2018-06-01 DOI: 10.33762/bsurg.2018.160105

Falih Waheed Hashim A

引用次数: 0

RECURRENT PILOMATRIXOMA 复发性PILOMATRIXOMA

Basrah Journal of Surgery Pub Date : 2018-06-01 DOI: 10.33762/bsurg.2018.160109

A. A.

引用次数: 0

COMPARISON BETWEEN SINGLE DRAIN VERSUS TWO DRAINS IN THE PREVENTION OF POSTMASTECTOMY SEROMA 单管引流与双管引流预防乳腺切除术后血清肿的比较

Basrah Journal of Surgery Pub Date : 2018-06-01 DOI: 10.33762/bsurg.2018.160113

A. A

引用次数: 1