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Autoamputated Leiomyoma of the Uterus as a Rare Cause of the Mechanical Bowel Obstruction – Report of a Case

100%

Rubinkiewicz M., Kenig J., Zbierska K., Lasek A.

Polish Journal of Surgery

2015

vol. 86

issue 7

341-344

Mechanical obstruction of the gastrointestinal tract is one of the most common causes of the emergency surgical intervention. A rare cause of such condition might be the effect of the external pressure on the intestine exerted by i. e. tumor, lymph node package, aneurysm of the abdominal aorta. An extremely rare cause is the pressure of the large loose mass located in the peritoneal cavity called “loose body”. We present a case of the mechanical bowel obstruction caused by a giant loose autoamputated leiomyoma of the uterus lying free in the peritoneal cavity. According to our best knowledge it is the largest described loose body in the literature. Moreover, we present a literature review regarding this issue.

Risk Factors for Wound Dehiscence after Laparotomy – Clinical Control Trial

76%

Kenig J., Richter P., Żurawska S., Lasek A., Zbierska K., Nowak W.

Polish Journal of Surgery

2012

vol. 84

issue 11

565-573

Described in the literature dehiscence rate in the adult population is 0.3-3.5%, and in the elderly group as much as 10%. In about 20-45% evisceration becomes a significant risk factor of death in the perioperative period. The aim of the study was to identify the main risk factors for abdominal wound dehiscence in the adult population. Material and methods. The study included patients treated in the 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow in the period from January 2008 to December 2011, in which at that time laparotomy was performed and was complicated by wound dehiscence in the postoperative period. For each person in a research group, 3-4 control patient were selected. Selection criteria were corresponding age (± 2-3 years), gender, underlying disease and type of surgery performed. Results. In 56 patients (2.9%) dehiscence occurred in the postoperative period with 25% mortality. The group consisted of 37 men and 19 women with the mean age of 66.8 ± 12.6 years. Univariate analysis showed that chronic steroids use, surgical site infection, anastomotic dehiscence/fistula in the postoperative period and damage to the gastrointestinal tract are statistically significant risk factors for dehiscence. Two first of these factors occurred to be independent risk factors in the multivariate analysis. In addition, due to the selection criteria, a group of risk factors should also include male gender, emergency operation, midline laparotomy, colorectal syrgery and elderly age (> 65 years). Logistic regression analysis did not show that a particular surgeon, time of surgery or a particular month (including holiday months) were statistically significant risk factor for dehiscence. Conclusions. Wound dehiscence is a serious complication with relatively small incidence but also high mortality. Preoperative identification of risk factors allows for a more informed consent before patient’s treatment and to take measures to prevent or minimize the consequences of complication associated with it.

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2 Polish Journal of Surgery

1 2014

1 2012

2 Kenig J.

2 Lasek A.

2 Zbierska K.

1 Nowak W.

1 Richter P.

1 Rubinkiewicz M.

1 Żurawska S.

Search results

Autoamputated Leiomyoma of the Uterus as a Rare Cause of the Mechanical Bowel Obstruction – Report of a Case

Risk Factors for Wound Dehiscence after Laparotomy – Clinical Control Trial