Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Mar 2010
Management algorithm for pneumatosis intestinalis and portal venous gas: treatment and outcome of 88 consecutive cases.
Pneumatosis intestinalis (PI) and portal venous gas (PVG) historically mandated laparotomy due to the high mortality rate associated with mesenteric ischemia. Computed tomography (CT) can identify PI/PVG in patients with ischemic emergencies and benign idiopathic conditions. ⋯ With greater sensitivity of modern CT scans, PI and PVG are being detected in patients with a wide range of surgical and non-surgical conditions. This clinical algorithm can identify subgroups to direct surgical intervention for acute ischemic insults and prevent non-therapeutic laparotomies for benign idiopathic PI and PVG.
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J. Gastrointest. Surg. · Mar 2010
Surgery for small bowel perforation in an Asian population: predictors of morbidity and mortality.
Peritonitis from small bowel perforation is associated with prohibitive morbidity and mortality rates. The aims of our study were to review our institution's experience in the surgical management of small bowel perforation and to identify factors that could predict morbidity and mortality. ⋯ Surgery for small bowel perforation is associated with significant morbidity and mortality rates. Patients with more severe peritonitis and physiological derangement were more likely to fare worse.
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J. Gastrointest. Surg. · Mar 2010
Comparative StudyProtective effects of early CD4(+) T cell reduction in hepatic ischemia/reperfusion injury.
CD4(+) T cells contribute to disturbances of liver microcirculation after warm ischemia/reperfusion (I/R). The aim of this study was to investigate a possible protective role of FTY720 (Sphingosine-1 phosphate receptor agonist) in this setting. ⋯ In conclusion, FTY720 ameliorates the microcirculatory, biochemical, and histological manifestations of hepatic I/R injury by preventing T cell infiltration. These results indicate that T cells are pivotal mediators in hepatic I/R and may have important implications early after liver transplantation and in warm ischemia.