Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
-
J Coll Physicians Surg Pak · Jan 2023
Case ReportsA Rare Cause of Gastrointestinal Bleeding: Successful Repair of a Primary Aorto-enteric Fistula.
Aorto-enteric fistula is a surgical emergency with potentially deadly results. Urgent surgical exploration and repair can lower mortality by 50%. Retroperitoneal fibrosis, mycotic aortic aneurysm, and infectious aortitis can mimic this condition on imaging and lead to unfavourable outcomes. ⋯ Here, we present a 67-year female with a primary aorto-enteric fistula. She underwent open repair of the abdominal aortic aneurysm using a prosthetic graft and primary anastomosis of the intestine. Key Words: Aorto-enteric fistula, Gastrointestinal bleeding, Aortic aneurysm.
-
J Coll Physicians Surg Pak · Jan 2023
Observational StudyPrognostic Markers after Hepatic Function Impairment in Patients with Pancreatic Adenocarcinoma.
To determine the factors affecting survival after hepatic failure in patients with pancreatic adenocarcinoma (PAC) who developed hepatic dysfunction accompanied by hyperbilirubinemia. ⋯ Pancreatic adenocarcinoma, CA 19-9, Hepatic failure, Prognosis, Survival.
-
J Coll Physicians Surg Pak · Jan 2023
Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction.
This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by 3D Slicer software to reconstruct the three-dimensional skull. ⋯ The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment. Key Words: Foramen ovale, Computed tomographic angiography, 3-Dimensional anatomy.
-
Efficiency of various inflammation-based indices, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), C-reactive protein/lymphocyte ratio (CLR), albumin/globulin ratio (AGR), haemoglobin, albumin, lymphocyte, and platelet (HALP), systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI), was examined in predicting mortality in COVID-19 patients. The study population consisted of 827 COVID-19 patients, including 733 survivors and 94 non-survivors. Compared with the survivor group, the NLR, PLR, CLR, and SII values of the non-survivor group were markedly higher; however, the LMR, PNI, HALP and AGR values were markedly lower. ⋯ PNI had the largest area under the curve to predict mortality, followed by CLR, NLR, and other indexes. This data revealed that PNI, NLR, and CLR are independent factors of mortality in COVID-19 patients among inflammation-based indexes. Key Words: COVID-19 mortality, Prognostic nutritional index, C-reactive protein/lymphocyte ratio, Neutrophil/lymphocyte ratio.
-
J Coll Physicians Surg Pak · Jan 2023
Case ReportsA Rare Case of Aortoenteric Fistula: Secondary Aortoesophageal Fistula.
Although aortoenteric fistula has been recognised for more than 50 years and has been rapidly diagnosed and treated, mortality is still very high due to some serious complications such as sepsis or massive haemorrhage. It has been traditionally classified into two groups; primary (PAEF) and secondary (SAEF). ⋯ In this case report, we describe a case of SAEsF, which had an atypical presentation and fatal outcome. Key Words: Abdominal aortic aneurysm, Aortoenteric fistula, Aortoesophageal fistula.