In situ reconstruction with autologous graft in the treatment of secondary aortoenteric fistulas: A retrospective case series

We report our surgical approach to SAEF consisting in removal of the infected graft and in situ reconstruction using an autologous venous graft.Seven consecutive patients with SAEF treated with graft removal and in situ reconstruction using an autologous venous graft from 2008 to 2017 were reviewed. Six of seven patients (86%) survived 30-day. In one case a graft thrombosis and acute lower limb ischemia occurred requiring re-operations. All patients received injective antibiotic therapy for 20 days, followed by oral therapy for 3 months. There were no major complications at long-term follow-up.Our results suggest that superficial femoral vein reconstruction of the abdominal aorta for SAEF is effective with an acceptable in-hospital mortality and low rate of major complications. We stress the importance of the deep femoral veins to create the graft because the large saphenous vein is often affected by significant intimal hyperplasia that can cause steno-occlusive complications.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research

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ConclusionAs deep neck space infections can be life-threatening, clinicians must be aware and not underestimate their potential severity. Lemierre's syndrome is a complication difficult to recognize, which requires additional awareness of the many possible presentations, for appropriate diagnostic studies and therapeutic plan.
Source: IDCases - Category: Infectious Diseases Source Type: research
We present the case of a woman with a severe clinical history of antiphospholipid syndrome and persistent positivity for lupus anticoagulant, IgG anticardiolipin and IgG anti- β2Glycoprotein I antibodies. An acute clinical onset characterized by severe abdominal pain immediately followed by circulatory shock and histological colonic small vessel thrombosis pattern pointed to a diagnosis of ischemic colitis. The subsequent rapid onset of pulmonary alveolitis and heart fai lure associated to subendocardial hypoperfusion led to a diagnosis of definite catastrophic antiphospholipid syndrome (CAPS). Conventional triple the...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
We describe a case of bullous leg cellulitis secondary to Serratia marcescens in a patient with a complex background including well-controlled HIV and venous insufficiency secondary to multiple deep vein thrombosis. Despite appropriate antibiotic therapy with meropenem, her condition deteriorated, requiring intensive care unit support. She was reviewed multiple times by the surgical teams, who felt that surgical intervention was not warranted. After a switch in antibiotics to ciprofloxacin, she made a sustained and complete recovery. S. marcescens cellulitis is a rare entity, but certain clinical features are common to mo...
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Case Reports Source Type: research
CONCLUSION: A correct and early diagnosis, prompt implementation of adequate antimicrobial therapy, and focus control, when indicated, are critical to a better prognosis. PMID: 31783013 [PubMed - as supplied by publisher]
Source: Jornal de Pediatria - Category: Pediatrics Authors: Tags: J Pediatr (Rio J) Source Type: research
CONCLUSION: Orbital cellulitis in children is a serious infection and requires close collaboration between the ophthalmologist, otolaryngologist, and pediatrician in order to be diagnosed and treated early so as to improve the prognosis for vision and life. PMID: 31722808 [PubMed - as supplied by publisher]
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
We report the first paediatric case of splenic infarction following acute Mycoplasma pneumoniae infection with induction of anti-prothrombin (aPT) antibodies. A 12-year-old boy was admitted to the paediatric emergency department for a left pleuropneumonia and a splenic infarction. aPT antibodies were transitorily detected. The patient recovered fully after antibiotic therapy and a 3-month course of anticoagulation treatment. Antiphospholipid (aPL) antibodies induced by acute infections have already been reported but cases of clinically relevant thrombosis remain rare. The pathogenicity of aPT antibodies is discussed here. ...
Source: Archives de Pediatrie - Category: Pediatrics Authors: Tags: Arch Pediatr Source Type: research
[Acetabular revision arthroplasty with a novel cementless augment-and-modular-cage system (MRS-C) : Surgical technique and preliminary clinical results]. Oper Orthop Traumatol. 2019 Nov 13;: Authors: Wirtz DC, Wacker M, Jaenisch M, Gravius S, Roessler PP Abstract OBJECTIVE: Optimal reconstruction of acetabular anatomy and primarily stable bridging even of large bone defects in hip revision surgery by intraoperative cementless application of highly modular components of the MRS-TITAN Comfort (MRS-C) system according to the augment-and-modular-cage principle. INDICATIONS: Acetabular defect sit...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
ConclusionAs deep neck space infections can be life-threatening, clinicians must be aware and not underestimate their potential severity. Lemierre's syndrome is a complication difficult to recognize, which requires additional awareness of the many possible presentations, for appropriate diagnostic studies and therapeutic plan.
Source: IDCases - Category: Infectious Diseases Source Type: research
Conclusion and Relevance: Our results suggest that intravenous therapy with MCs is generally safe for prolonged courses that do not exceed 14 days as compared with PICC lines, which can be placed for months. There is still limited evidence for the use of MCs between 14 and 28 days of therapy. This study can help guide our selection of intravenous catheters for the purpose of outpatient antimicrobial therapy. PMID: 31565960 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - Category: Drugs & Pharmacology Authors: Tags: Ann Pharmacother Source Type: research
CONCLUSION: Although the number of patients included in the study was small, our short-term results suggest a good applicability of PICCs in the outpatient i. v. antimicrobial therapy for treatment of periprosthetic joint infection. Catheter-associated complications could not be observed in our collective. The successful infection control in all cases despite proven difficult-to-treat infection is promising. PMID: 31387123 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Orthopadie und Unfallchirurgie - Category: Orthopaedics Tags: Z Orthop Unfall Source Type: research
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