Acta Chirurgica Belgica最新文献

Late, Solitary Small Bowel Metastasis of Anaplastic Thyroid Cancer: A Case Report. 甲状腺间变性癌晚期孤立性小肠转移1例。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-07-18 DOI: 10.1080/00015458.2025.2536364

Margo Hendrickx, Ellen Peters, Paul Willemsen

{"title":"Late, Solitary Small Bowel Metastasis of Anaplastic Thyroid Cancer: A Case Report.","authors":"Margo Hendrickx, Ellen Peters, Paul Willemsen","doi":"10.1080/00015458.2025.2536364","DOIUrl":"https://doi.org/10.1080/00015458.2025.2536364","url":null,"abstract":"BackgroundAnaplastic thyroid carcinoma (ATC) is a rare type of thyroid cancer that is characterized by its rapid onset and progression. It tends to metastasize to various organs, including the lungs, brain, bones and, less commonly, the small bowel.Case presentationThis case report describes a 74-year-old woman who had small bowel metastasis leading to obstruction three years after diagnosis and local resection of ATC, followed by adjuvant chemotherapy.The patient presented at the emergency department with abdominal pain and vomiting.A CT-scan of the abdomen showed signs of intestinal perforation, combined with diffuse dilatation of the ileal small bowel, for which a segmental enterectomy was performed.ResultsHistological findings of the resected small bowel diagnosed the tumor as a jejunal metastasis of an ATC. The morphology of this lesion was compared to that of this patient's ATC.ConclusionWe present a rare case of small bowel metastasis from ATC which has previously been described in just a few case reports in the medical literature. Therefore, this case report contributes to the limited knowledge available on this condition.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Parental satisfaction and long term standardized outcome evaluation after percutaneous endoscopic vs laparoscopic gastrostomy in children. 儿童经皮内镜与腹腔镜胃造口术后家长满意度及长期标准化结果评价。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-18 DOI: 10.1080/00015458.2025.2520698

Thomas Pattyn, Matthias Verbesselt, Kirsten Das, Ilse Hoffman, Marguerite Stas, Tania Claeys, Marc Miserez

{"title":"Parental satisfaction and long term standardized outcome evaluation after percutaneous endoscopic vs laparoscopic gastrostomy in children.","authors":"Thomas Pattyn, Matthias Verbesselt, Kirsten Das, Ilse Hoffman, Marguerite Stas, Tania Claeys, Marc Miserez","doi":"10.1080/00015458.2025.2520698","DOIUrl":"10.1080/00015458.2025.2520698","url":null,"abstract":"Introduction: Percutaneous endoscopic (PEG) and laparoscopic gastrostomy (LG) are two widely used techniques for gastrostomy placement in infants. We aimed to compare the risk of complications using a validated grading system and parent satisfaction.Methods: Infants undergoing gastrostomy placement in a tertiary referral center were retrospectively included. Local and general complications were graded using the Clavien-Dindo (CD)system and categorized as early (≤ 30 days) vs late (>30 days) postoperatively. Parent satisfaction was evaluated prospectively using a questionnaire (Numeric Rating Scale 0- 10).Results: Out of 102 patients, 52 underwent LG and 50 PEG. General complications (CD IIIa, IIIb and IV) were rare and occurred all late (n = 3), local complications were common: twice as much minor local early complications occurred in the LG cohort, however this was not statistically significant (28.8% vs 14.0%; p = 0.092). There was a trend toward more major local late CD IIIb complications in the PEG group, but this was not statistically significant (20.4% vs 8.0%; p = 0.088). After button removal, there was a higher risk of gastrocutaneous fistula requiring surgical closure after LG (53.1% vs 26.7% after PEG; p = 0.003). Parental satisfaction was high in both groups (mean score 8.3 for PEG vs 7.9 for LG; p = 0.341).Conclusion: While the risk of general complications after gastrostomy placement is low, local complications are common. However not significant, PEG was associated with a higher risk of major long-term local complications, while LG required more surgical closures after button removal. Parental satisfaction was high in both groups. Further prospective comparisons are needed.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-8"},"PeriodicalIF":0.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical reconstruction of the columella after necrosis caused by an infantile hemangioma. 婴儿血管瘤坏死后小柱的外科重建。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-17 DOI: 10.1080/00015458.2025.2520785

Rocío Terrados, María San Basilio, Manuel de la Torre, Concepción Lorca-García, Beatriz Berenguer

{"title":"Surgical reconstruction of the columella after necrosis caused by an infantile hemangioma.","authors":"Rocío Terrados, María San Basilio, Manuel de la Torre, Concepción Lorca-García, Beatriz Berenguer","doi":"10.1080/00015458.2025.2520785","DOIUrl":"10.1080/00015458.2025.2520785","url":null,"abstract":"Background: Infantile hemangiomas are common vascular tumors in childhood that usually undergo spontaneous involution. However, complications may arise, particularly in visible areas such as the centrofacial region, leading to significant aesthetic and functional sequelae. Columellar necrosis is a rare but challenging complication requiring specialized reconstruction techniques.Methods: This report presents two cases of columellar necrosis caused by infantile hemangiomas. Reconstruction was achieved using a 3-component technique: cartilage grafts for tip support, oral vestibule mucosal flaps for lateral lining, and cutaneous turn out flaps from the columellar stumps for anterior skin coverage.Results: Both patients achieved excellent functional and aesthetic outcomes. The described technique allowed for reliable reconstruction of the columella, addressing both structural integrity and cosmetic appearance.Conclusion: Reconstruction of columellar defects, particularly in pediatric cases, is challenging due to the columella's small size and challenging anatomy. The described 3-component technique offers a reproducible and effective approach for isolated columellar defects, ensuring satisfactory functional and aesthetic results.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-6"},"PeriodicalIF":0.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cervico-thoracic paraganglioma associated with Horner's syndrome: a case report. 颈胸副神经节瘤合并霍纳综合征1例。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-09 DOI: 10.1080/00015458.2025.2512488

Naïla El Nakadi, Jâd Abi-Khalil, Sarah Landenne, Isabelle De Quin, Jean Lemaitre

{"title":"Cervico-thoracic paraganglioma associated with Horner's syndrome: a case report.","authors":"Naïla El Nakadi, Jâd Abi-Khalil, Sarah Landenne, Isabelle De Quin, Jean Lemaitre","doi":"10.1080/00015458.2025.2512488","DOIUrl":"10.1080/00015458.2025.2512488","url":null,"abstract":"Background: Cervico-thoracic paragangliomas are rare hypervascular neuroendocrine tumors, with high morbidity and mortality due to locally invasive growth. They are often misdiagnosed in patients with cervical masses. Horner's syndrome, in this case, results from a lesion of the stellate ganglion. Only a few cases in the literature describe paragangliomas affecting the stellate ganglion.Case report: We report the case of a 61-year-old female with a cervico-thoracic paraganglioma associated with Horner's syndrome. She had no significant medical history. Cervical computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large, highly vascularized antero-superior mediastinal mass measuring 6.8 cm x 5 cm x 9 cm, surrounding the left subclavian and carotid arteries, and slightly compressing the trachea, esophagus, and innominate vein. Surgery provided the definitive diagnosis through histopathological analysis. We highlight the different types of paragangliomas and the challenges in diagnosis. A 2-year follow-up with CT and PET-CT scans confirmed no recurrence of the lesion.Conclusions: Paragangliomas are rare, slow-growing neuroendocrine tumors that may appear wherever autonomic ganglia are present. Clinical presentations vary, including lesions of the stellate ganglion causing ipsilateral Horner's syndrome. Paragangliomas should be considered in the differential diagnosis of cervico-thoracic masses. Treatment involves complete surgical resection while preserving neurovascular structures.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-4"},"PeriodicalIF":0.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Downstaging and R0 resection of initially unresectable metastatic well-differentiated grade-3 pancreatic neuroendocrine tumor: a case report. 最初不可切除的转移性高分化3级胰腺神经内分泌肿瘤的降期和R0切除：1例报告。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-06 DOI: 10.1080/00015458.2025.2515325

Arthur Houbiers, Joseph Weerts, Ghislain Houbiers, Roland Materne, Nancy Witvrouw, Noella Blétard, Benoit Monami, Christian Focan, Ivan Borbath

{"title":"Downstaging and R0 resection of initially unresectable metastatic well-differentiated grade-3 pancreatic neuroendocrine tumor: a case report.","authors":"Arthur Houbiers, Joseph Weerts, Ghislain Houbiers, Roland Materne, Nancy Witvrouw, Noella Blétard, Benoit Monami, Christian Focan, Ivan Borbath","doi":"10.1080/00015458.2025.2515325","DOIUrl":"10.1080/00015458.2025.2515325","url":null,"abstract":"Introduction: High-grade pancreatic neuroendocrine tumors are rare, and most of them are well differentiated. Management of this type of tumor is not yet well established.Methods: A 28-year-old woman was referred to our hospital for a well-differentiated grade-3 pancreatic neuroendocrine tumor with multiple liver metastases. The patient received neoadjuvant therapy consisting of combination of Capecitabine/Temozolomide chemotherapy and somatostatin analogue.Results: An excellent regression was observed on both pancreatic and hepatic lesions, and therefore, an aggressive surgical management could be performed with a two-step scheme. Adjuvant hormono-chemotherapy was administered between the two surgeries. The patient achieved six years of disease-free survival following the last therapy.Discussion and conclusion: We highlight the difference between well and poorly differentiated high-grade neuroendocrine neoplasia and report that aggressive surgery is a valid option even in metastatic presentation at diagnosis.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A prospective diagnostic accuracy study of the Alvarado score in a Croatian hospital - is it time for a final conclusion? 克罗地亚一家医院对阿尔瓦拉多评分的前瞻性诊断准确性研究——是得出最终结论的时候了吗？

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-03 DOI: 10.1080/00015458.2025.2512279

Branko Bakula, Ante Bogut, Andrija Karačić, Maja Bakula, Antonio Marić, Vanja Radišić Biljak

{"title":"A prospective diagnostic accuracy study of the Alvarado score in a Croatian hospital - is it time for a final conclusion?","authors":"Branko Bakula, Ante Bogut, Andrija Karačić, Maja Bakula, Antonio Marić, Vanja Radišić Biljak","doi":"10.1080/00015458.2025.2512279","DOIUrl":"10.1080/00015458.2025.2512279","url":null,"abstract":"Background: The diagnosis of acute appendicitis (AA) still represents a considerable problem for surgeons, with a relatively high rate of false positive findings still present. Thus, the aim of our study was to evaluate the diagnostic accuracy of the Alvarado scoring system based on the prospectively included subjects who presented to the emergency department with suspected AA.Methods: From June 2018 to May 2020, 176 adult patients examined in the Emergency surgical department of University Hospital Sveti Duh with suspicion of AA were prospectively included in the study. The decision on the need for surgery in all patients was made by the same surgeon based only on clinical judgment and remained independent of any diagnostic scoring system.Results: Fifty-eight (33.0%) of them were operated with negative appendectomy rate of 17.2%. Results showed that the surgeon's decision-making process is superior to the Alvarado scoring system (sensitivity and specificity were 96 and 92.06% vs. 84 and 87.30%, respectively).Conclusion: The Alvarado scoring system proved to be a worse predictor of the diagnosis of AA compared to the assessment of an experienced surgeon and is not an adequate diagnostic tool for confirming the diagnosis. Only in a narrow group of patients in whom, based on the clinical examination, an indication for surgery has already been established, the Alvarado scoring system can potentially be useful in excluding the diagnosis with considerable caution in terms of close follow-up of the patient.Abbreviations: MSCT: multislice computed tomography; AA: acute appendicitis.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-5"},"PeriodicalIF":0.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-esophagectomy aortogastric-tube fistula treated successfully with TEVAR: case report and review of the literature. TEVAR成功治疗食管切除术后主动脉胃管瘘1例报告及文献复习。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-03-03 DOI: 10.1080/00015458.2025.2470535

Natasha Hasemaki, Dimitrios Schizas, Chrysovalantis Vergadis, Stavros Sougioultzis, Athanasios Katsargyris, Christos Klonaris

{"title":"Post-esophagectomy aortogastric-tube fistula treated successfully with TEVAR: case report and review of the literature.","authors":"Natasha Hasemaki, Dimitrios Schizas, Chrysovalantis Vergadis, Stavros Sougioultzis, Athanasios Katsargyris, Christos Klonaris","doi":"10.1080/00015458.2025.2470535","DOIUrl":"10.1080/00015458.2025.2470535","url":null,"abstract":"Background: Aortogastric-tube fistula is a rare but fatal complication of esophagectomy, most commonly induced by anastomotic leakage and peptic ulcer formation.Methods: We report a rare case of a 55-year-old male patient presenting with an aortogastric-tube fistula located in the gastric conduit due to a recurrence of esophageal carcinoma.Results: The patient was treated successfully with Thoracic Endovascular Aortic Repair (TEVAR) followed by esophageal stent placement to relieve dysphagia.Conclusion: Although aortogastric-tube fistula is an extremely rare entity, the advent of esophageal cancer surgery, has led to the recognition of aortogastric-tube fistula with increasing frequency in the literature. Herein, we provide a comprehensive review of the literature, focusing on the pathophysiology, time interval between surgery and presentation, type of treatment and survival of reported cases with post-esophagectomy aortogastric-tube fistula.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"156-163"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TRUMATCH^TM Graft Cage-Long Bone as a solution for tibial bone defect in traumatic aseptic non-union: a case report. TRUMATCH TM移植物笼-长骨治疗外伤性无菌骨不连胫骨缺损1例报告。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-02-18 DOI: 10.1080/00015458.2025.2467482

Maud A M Vesseur, Isobel M Dorling, Bert Boonen, Kostan W Reisinger, Raoul van Vugt

{"title":"TRUMATCHTM Graft Cage-Long Bone as a solution for tibial bone defect in traumatic aseptic non-union: a case report.","authors":"Maud A M Vesseur, Isobel M Dorling, Bert Boonen, Kostan W Reisinger, Raoul van Vugt","doi":"10.1080/00015458.2025.2467482","DOIUrl":"10.1080/00015458.2025.2467482","url":null,"abstract":"Background: Tibial fractures, with an annual incidence of 51.7 per 100.000 adults, often result in complications like non-union and infection, particularly in open fractures. Non-union rates after intramedullary nailing are 9.7%. Hypertrophic non-union stems from unstable fracture sites, while atrophic non-union arises from inadequate biological environments. Treatment involves rigid bone fixation for hypertrophic non-union and combining biological tissue supply with mechanical stability for atrophic non-unions. This case report outlines a complex tibial non-union post-high-impact injury, detailing the surgical technique and TRUMATCHTM Graft Cage-Long Bone usage. In addition, we outlined the current literature on this topic.Case report: A male patient suffered a traumatic Gustilo II comminuted tibia and fibula fracture, Lisfranc injury and a Schatzker I tibial plateau fracture of the right leg. During follow-up the patient developed an aseptic non-union with eight-centimeter anterolateral bone defect after primary surgery. Surgical intervention was performed using the three-dimensional printed TRUMATCHTM Graft Cage-Long Bone. At one year follow-up, clinical and radiological consolidation of the right tibia was seen.Conclusion: This case report describes a challenging case of aseptic traumatic non-union of the tibia with a critical-sized defect treated with a novel patient-specific implant in a one-stage procedure. The application of the TRUMATCHTM Graft Cage-Long Bone is promising and warrants further investigation in larger, more controlled studies to substantiate our findings.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"148-155"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety analysis of a multispecialty surgical volunteerism mission over 13 years - age alone is not a contraindication. 十三年来多专科外科志愿服务任务的安全分析--年龄本身并不矛盾。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-04-28 DOI: 10.1080/00015458.2021.1920669

Shekhar Gogna, Mahir Gachabayov, Rifat Latifi

{"title":"Safety analysis of a multispecialty surgical volunteerism mission over 13 years - age alone is not a contraindication.","authors":"Shekhar Gogna, Mahir Gachabayov, Rifat Latifi","doi":"10.1080/00015458.2021.1920669","DOIUrl":"10.1080/00015458.2021.1920669","url":null,"abstract":"Introduction: About five billion people worldwide lack access to safe surgery and multispecialty surgical volunteerism missions (SVMs) offer a plausible solution to this problem. This study aimed to evaluate the outcomes of elderly patients operated on over 13 surgical missions between 2006 and 2019 from 'Operation Giving Back Bohol' (OGBB) Tagbilaran, Philippines.Patients and methods: This was a retrospective analysis of prospectively collected data on all patients treated during SVM over 13 years (2006-2019). Non-elderly (age 16-64 years) were compared with the elderly (age ≥ 65 years) for pre-, intra-, and postoperative variables. Multivariable logistic regression was utilized to identify independent predictors of postoperative complications.Results: Of 1184 patients, the majority (1030) was in the non-elderly group and 154 in the elderly. The mean age was 36 ± 13.6 and 68.3 ± 3.8 years in the non-elderly and elderly groups, respectively. Comorbidities, type of surgery, type of anesthesia, operating time, estimated blood loss, estimated blood loss, need for blood transfusion, postoperative complication rates, comprehensive complication index, length of hospital, ICU requirement, and mortality rates stay did not significantly differ between the groups. Multivariable logistic regression found pelvic surgery (OR (95%CI)=3.7 (1.3-10.8); p=.01), hypertension (OR (95%CI)=8.4 (2.2-32.9); p<.01), and intraoperative blood loss (OR (95%CI) = 1.007 (1.005-1.009); p<.01) to be independent predictors of postoperative complications.Conclusions: Elderly patients may safely undergo general surgery procedures in surgical volunteer missions, and age alone should not preclude them.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"132-138"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38925919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to address post-Roux-en-Y gastric bypass late dumping in a patient with a history of Nissen fundoplication converted to bypass for obesity. 如何处理有尼森胃底扩张史的肥胖患者转行胃分流术后roux -en- y胃分流术晚期倾倒。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-03-04 DOI: 10.1080/00015458.2025.2468063

Jean-Philippe MmK Magema, Jacques Himpens

{"title":"How to address post-Roux-en-Y gastric bypass late dumping in a patient with a history of Nissen fundoplication converted to bypass for obesity.","authors":"Jean-Philippe MmK Magema, Jacques Himpens","doi":"10.1080/00015458.2025.2468063","DOIUrl":"10.1080/00015458.2025.2468063","url":null,"abstract":"Introduction: Reversal of Roux-en-Y gastric bypass (RYGB) may be indicated for possible side effects such as malnutrition, intolerance, dumping syndrome, or late dumping. Reversal can however induce significant gastro-esophageal reflux disease (GERD).Method: We report the case of a 55 years old Caucasian woman, who had undergone conversion of Nissen fundoplication performed for GERD (Grade B) into RYGB because of recurrent reflux, though Grade A esophagitis and increasing obesity (37.5 kg/m2 BMI). She developed invalidating symptoms of late dumping syndrome and severe diarrhea. Pre- and postoperative evaluation an eso-gastroscopy with esophagitis grade evaluation. Treatment consisted of physiologic reversal of the RYGB, by reimplantation of the alimentary limb into the remnant stomach.Result: Pre-reversal endoscopy showed Grade A esophagitis. Oral glucose test demonstrated severe hypoglycemia persisting till 120 min post-ingestion and clinical symptoms of hypoglycemia (Whipple triad) (40 to 53 mg/dl). Three months after reversal the diagnostic tests had significantly improved, both in terms of glucose metabolism and GERD symptoms. At 22 months after surgery, the patient still did not suffer from diarrhea anymore, her glycemic profile was stable under antidiabetic medications and her BMI raised to 29 kg/m2.Discussion and conclusion: Reversal of Roux-en-Y gastric bypass by incorporation of the alimentary limb between the gastric pouch and the gastric remnant seems to successfully address the dual issue of post-RYGB late dumping and preventing GERD, the different mechanisms involved will be explained latter in this paper.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"170-174"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0