Novel method for non-traumatic creation of a colostomy.

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
ANZ Journal of Surgery (Impact Factor: 1.12). 09/2012; 82(9):661-2. DOI: 10.1111/j.1445-2197.2012.06160.x
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    ABSTRACT: Corticosteroids and non-steroidal anti-inflammatory drugs are widely used for the treatment of rheumatic conditions, but their gastrointestinal damage significantly limits their use. Sigmoid diverticular abscess perforation (SDAP) is a very serious complication of diverticular disease. To determine the aetiology of large bowel SDAP in rheumatic conditions. 64 patients with SPAD and 320 controls from a similar geographical area and of similar socioeconomic status were studied. The results showed that independently of rheumatic diagnosis corticosteroid treatment is strongly associated with SDAP (OR 31.9 (95% CI 6.4 to 159.2; p<0.001), and non-steroidal anti-inflammatory drugs only weakly associated (OR 1.8 (95% CI 0.96 to 3.4); p = 0.069). A rheumatic diagnosis is also strongly associated with the development of SDAP (OR 3.5 (95% CI 1.9 to 6.7); p<0.001). SDAP has serious implications for patients and consumes many healthcare resources. Patients and physicians should be warned of this potential complication.
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    ABSTRACT: Both AIDS-related infections and neoplasms of the gastrointestinal tract may be manifest by a clinical picture of acute abdominal disease. Severe abdominal pain may be seen in this population even in the absence of true surgical complications such as perforation, abscess formation, or obstruction. Localizing signs and symptoms are frequently misleading due to underlying immunosuppression, debilitation, and prior or current antibiotic use. CT assumes a critical role in evaluation of the symptomatic AIDS patient, providing evaluation of the entire abdomen and pelvis including lymph nodes, solid viscera, and the bowel itself. CT is thus the modality of choice for characterization of AIDS-related abdominal disease and for direction of appropriate therapy.
    Radiologic Clinics of North America 10/1994; 32(5):1023-43. · 1.83 Impact Factor
  • The acute abdomen in the immunocompromised host. . 1988. Surg. Clin. North Am 68 457-70.