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
Source: PubMed
  • Source
    [Show abstract] [Hide abstract]
    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.
    Annals of the Rheumatic Diseases 05/2004; 63(5):588-90. DOI:10.1136/ard.2003.010355 · 10.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Immunocompromised hosts are a heterogeneous group, including patients receiving transplants, those receiving chemotherapy for malignant disease, and those receiving steroids for autoimmune disease, as well as patients with AIDS. Each group has specific abdominal conditions, and the clinician must be familiar with the specific causes of the acute abdomen within each subset. The causes of the acute abdomen in immunocompromised patients may be divided into two broad categories: (1) those disorders that are closely associated with the immunocompromised state and (2) those processes that can occur in any patient regardless of the immune status. Physicians at every level of specialization must become familiar with the unusual complications that occur in this population and with the ways in which the underlying disease and its therapy can modify the clinical presentation and management of common abdominal conditions. This article outlines broad principles of common clinical findings and surgical therapy in these patients.
    Surgical Clinics of North America 05/1988; 68(2):457-70. · 1.93 Impact Factor
  • [Show abstract] [Hide abstract]
    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