Dahlgaardjennings6522

The COVID-19 pandemic has changed patient management in all sectors. All patients need to be examined for COVID-19, including in digestive surgery emergency cases. In this paper, we report four digestive surgery emergency cases with clinical and radiological findings similar to COVID-19.

We report four digestive surgery emergency cases admitted with fever and cough symptoms. Case 1 is a 75-year-old male with gastric perforation and pneumonia, case 2 is a 32-year-old female with intestinal and pulmonal tuberculosis, case 3 is a 30-year-old female with acute pancreatitis with pleuritis and pleural effusion, and the last case is a 56-year-old female with rectosigmoid cancer with pulmonal metastases. All the patients underwent emergency laparotomy, were hospitalized for therapy, and discharged from the hospital. After 1-month follow-up after surgery, 1 patient had no complaints, 2 patients had surgical site infection, and 1 patient died because of ARDS due to lung metastases.

For all four cases, the surgeries were done with strict COVID-19 protocol which included patient screening, examination, laboratory assessment, rapid test screening, and RT-PCR testing. There were no intrahospital mortalities and all the patients were discharged from the hospital. Three patients were followed-up and recovered well with 2 patients having surgical site infection which recovered within a week. However, 1 patient did not show up for the scheduled follow-up and was reported dead 2 weeks after surgery because of ARDS due to lung metastases.

Emergency surgery, especially digestive surgery cases, can be done in the COVID-19 pandemic era with strict prior screening and examination, and safety protocol.

Emergency surgery, especially digestive surgery cases, can be done in the COVID-19 pandemic era with strict prior screening and examination, and safety protocol.

colorectal cancer is a public health challenge in France. Cutaneous metastases are rare but they give evidence of poor prognosis.

88 years old female patient, with a previous history of hysterectomy, venous thrombosis outcomes of ankle fracture and stable multiple sclerosis without treatment. She came to emergency with peritonitis. CT scan showed a pneumoperitoneum, and a transverse colonic mass. A laparotomy was performed. This revealed a perforation of caecum, and an obstructive tumor of transverse colon. An extended right semi-colectomy was performed to remove both the perforate caecum and the tumor. The patient was discharged on the 7th post-operative day. DNA Repair inhibitor Examination confirm an adenocarcinoma pT3N0Mx. At follow up, a nodule was found on her forehead. The biopsy showed a metastasis of colon adenocarcinoma. A surgical resection was performed. To date the patient is well with no evidence of recurrent disease.

Cutaneous metastases are rare and there are no recommendations for their treatment. Surgical resection is the best choice, but radiotherapy may be an alternative.

Cutaneous metastases are rare and there are no recommendations for their treatment. Surgical resection is the best choice, but radiotherapy may be an alternative.

Acute gastrointestinal (GI) bleeding can be a life-threatening condition. This is usually diagnosed and managed by an upper GI tract endoscopy. When treating actively bleeding duodenal ulcers, surgical intervention, or arterial embolization by Interventional Radiology (IR) is warranted in the event of failed initial management. We present a patient with a significant GI bleed and failure of management through endoscopy, necessitating emergent surgical intervention.

An 87-year-old female presented to the emergency department after a fall. Her hemoglobin level dropped significantly and an esophagogastroduodenoscopy (EGD) revealed a large pool of blood in the stomach but had a limited view of an active bleed. The patient was taken emergently to the operating room (OR) where she underwent an exploratory laparotomy, gastroduodenostomy, suture ligation, and pyloroplasty. The following day, she had increased sanguineous output from her nasogastric (NG) tube. Re-evaluation was done with an EGD in the OR. The patient tolerated all procedures well and was transferred to a facility with IR capabilities for further management.

An EGD hours after gastroduodenostomy runs a high risk for perforation and is not the typical course of action. Given the lack of IR availability and concern for rebleeding, this procedure was performed in the OR to minimize risk.

A favorable outcome was achieved with this patient and hemostasis was confirmed with the post-operative EGD. Further studies will determine whether this approach is a viable option for facilities without IR until the patient can be transferred.

A favorable outcome was achieved with this patient and hemostasis was confirmed with the post-operative EGD. Further studies will determine whether this approach is a viable option for facilities without IR until the patient can be transferred.

Caudal epidural sacral injection is one of the most common conservative treatments for chronic low back pain with radiculopathy. Neurological deficit after injection is a rare complication that must be identified and treated properly.

We report a case of cauda equina syndrome that persisted until 3 months after injection. A 63-year-old man came to our department with severe lumbar canal stenosis who experienced motor weakness, buttocks numbness and voiding difficulties immediately after injection. His lower extremities improved after 24 h, but his neurogenic bladder problems and perianal numbness still persisted. We collaborated with our interdisciplinary teams to do a rehabilitation program, and the symptoms were alleviated and he fully recovered within three months.

Patients with severe stenosis can be best described from magnetic resonance imagery scans, and clinicians should be careful about the risks after injection ranging from transient complications to persistent spinal cord injury.

Patients with severe stenosis can be best described from magnetic resonance imagery scans, and clinicians should be careful about the risks after injection ranging from transient complications to persistent spinal cord injury.