1,721,104 research outputs found
Impact of postoperative cardiovascular complications on 30‐day mortality after major abdominal surgery: an international prospective cohort study
No full text: Cardiovascular complications after major surgery are associated with increases in morbidity and mortality. There is confusion over definitions of cardiac injury or complications, and variability in the assessment and management of patients. This international prospective cohort study aimed to define the incidence and timing of these complications and to investigate their impact on 30-day all-cause mortality. We performed a prospective, international cohort study between January 2022 and May 2022. Data were collected on consecutive patients undergoing major abdominal surgery in 446 hospitals from 28 countries across Europe. The primary outcome measure was cardiovascular complications as defined by the Standardised Endpoints for Perioperative Medicine-Core Outcome Measures for Perioperative and Anaesthetic Care initiative up to 30 days after surgery. The secondary outcome was 30-day postoperative mortality. This study included 24,203 patients, of whom 611 (2.5%) developed cardiovascular complications. In total, 458 (1.9%) patients died within 30 days of surgery, of which 123 (26.9%) deaths were judged to be cardiac-related. Mortality rates were higher in patients who developed postoperative cardiovascular complications than in those who did not (19.8% vs. 1.4%), which persisted after risk adjustment (hazard ratio (95%CI) 4.15 (3.14-5.48)). We estimated an absolute risk reduction (95%CI) of 0.4 (0.3-0.5) in mortality in the absence of all cardiovascular complications. This would confer a relative risk reduction in mortality of 21.1% if all cardiovascular complications were prevented. Postoperative cardiovascular complications are relatively common and occur early after major abdominal surgery. However, over 1 in 5 postoperative deaths were attributable to these complications, highlighting an important area for future randomised trials
Solitary fibrous tumor of the omentum: Presentation of a case and literature review
Full text linkSolitary fibrous tumor (SFT) and hemangiopericytoma (HPC) were considered, since their firsts description in the literature, as separate entities. The World Health Organization (WHO) classification of soft tissue tumors in 2013 declared the term HPC obsolete, and considered these lesions as features of the extrapleural SFT category. Herein we present a rare case of SFT originating from the great omentum. A 68 years old woman was admitted to our hospital with acute abdominal pain. Computed tomography revealed a 142 x 102 x 100 mm solid mass located in the pelvis, that simulated an adnexal lesion. An explorative laparotomy was performed, and a mass of the great omentum with a significant vascular pedicle arising from a branch of the left gastroepiploic artery was revealed. The tumor was completely resected. Microscopically it was composed by non-organized and spindle-shaped cells exhibiting atypical nuclei, arranged in short fascicles, and was diagnosed as. An extensive search was conducted in public scientific databases for published articles on the topic, with the aim to comprehensively describe the demographic, clinical, pathological and prognostic features of SFT; 60 previous cases have been identified and reviewed
Elevated serum CA 19-9 level associated with a splenic cyst: which is the actual clinical management? Review of the literature
No full textSplenic cysts are relatively rare entities. The differential diagnosis for these lesions includes parasite infections, results of previous trauma or infarction, congenital forms, primitive splenic neoplasm or cystic metastasis. They can be either symptomatic, causing mainly abdominal pain, or asymptomatic, thus being diagnosed as in incidental finding during radiological examination for other clinical reasons: among these a raised serum level of CA 19-9 can be a case. It has been demonstrated that epidermoid and mesothelial congenital cyst can be associated with a pathological level of this tumor marker which is usually correlated to biliopancreatic and colonic carcinomas. The aim of the present study is to present the case of an asymptomatic epidermoid splenic cyst associated with a continuous increase of CA 19-9 and to describe the applied clinical workup and surgical management by laparoscopic total splenectomy. Moreover, to analyze the demographics, clinical and pathological features of these infrequent lesions and to confront our therapeutic management with that of the other reported cases, we conducted a systematic review of the literature
Spontaneous retropharyngeal and mediastinal emphysema: case report
No full textWe report the case of an uncommon pathological condition affecting a previously healthy 14-year-old
boy, who came to the Emergency Room because of sudden, acute lateral-cervical neck pain not related to
any other symptom, disease, traumatic event or dangerous behaviour.
The diagnosis of spontaneous retropharyngeal and upper mediastinal emphysema was made by
means of neck X-ray and neck and thorax CT scan, while the X-ray of the upper digestive tract and the
fiberoptic laryngoscopy did not detect any oesophageal fistula or lesions of the pharynx and larynx.
Antibiotics and only fluids intake in order to avoid more dangerous complications was the unique
successful treatment; in 3 days time the boy was completely pain-free and back to normal activitie
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