The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
P. R. R. Rosias - One of the best experts on this subject based on the ideXlab platform.
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Superior mesenteric artery syndrome in a 15-year-old boy during Ramadan.
European journal of pediatrics, 2013Co-Authors: M. E. C. Bakker, R. Van Delft, N. A. L. Vaessens, P. R. R. RosiasAbstract:A previously healthy 15-year-old boy who participated in Ramadan and recently suffered from a gastro-enteritis presented at the emergency room with abdominal pain, vomiting, and marked weight loss. Abdominal X-ray and computed tomography showed upper Gastrointestinal Obstruction and narrowing of the distance between superior mesenteric artery and aorta abdominalis. Through these findings, superior mesenteric artery syndrome was diagnosed. Treatment consisted of placement of a nasojejunal tube for enteral feeding until weight gain was substantial. Superior mesenteric artery syndrome is rare, with a prevalence varying between 0.013 and 0.3 %. It is characterized by compression of the third part of duodenum between aorta and superior mesenteric artery, thus causing signs and symptoms of upper Gastrointestinal Obstruction. Conclusion: In general, when signs and symptoms of upper Gastrointestinal Obstruction are accompanied with rapid weight loss, superior mesenteric artery syndrome should be considered.
Brian Badgwell - One of the best experts on this subject based on the ideXlab platform.
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In Search of the Optimal Outcome Measure for Patients with Advanced Cancer and Gastrointestinal Obstruction: A Qualitative Research Study
Annals of Surgical Oncology, 2020Co-Authors: Loretta A Williams, Eduardo Bruera, Brian BadgwellAbstract:Background Gastrointestinal Obstruction (GIO) is the most common indication for palliative surgical consultation in patients with advanced cancer. The purpose of this study is to delineate the symptom burden and experience of these patients. Patients and Methods Twenty patients with advanced cancer and GIO described symptoms at time of surgical consultation. We analyzed the content of interview transcripts and ranked symptoms by frequency and according to an assessment of relevance conducted by an expert panel (surgeons, palliative care physicians, nurses, and patients/caregivers). Results Among the 20 study patients, malignancy types included colorectal ( n = 9), gastric ( n = 4), urothelial/renal ( n = 3), and other ( n = 4), whereas sites of Obstruction were the small bowel ( n = 11), gastric outlet ( n = 3), and large bowel ( n = 6). Thirteen patients (65%) had received chemotherapy within 6 weeks. Imaging evidence of a primary/recurrent tumor was documented in 13 patients (65%), carcinomatosis in 11 (55%), and ascites in 16 (80%). Thirty patient symptoms were identified on qualitative interviewing. Seven GIO-specific items were identified as relevant by the expert panel and will be added to the core symptom assessment inventory for further testing. Conclusions We identified symptoms of importance that can be used to assess outcome after treatment of patients with advanced cancer and GIO. Testing for validity and reliability will be required before formal survey development.
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In Search of the Optimal Outcome Measure for Patients with Advanced Cancer and Gastrointestinal Obstruction: A Qualitative Research Study
Annals of surgical oncology, 2020Co-Authors: Loretta A Williams, Eduardo Bruera, Brian BadgwellAbstract:Gastrointestinal Obstruction (GIO) is the most common indication for palliative surgical consultation in patients with advanced cancer. The purpose of this study is to delineate the symptom burden and experience of these patients. Twenty patients with advanced cancer and GIO described symptoms at time of surgical consultation. We analyzed the content of interview transcripts and ranked symptoms by frequency and according to an assessment of relevance conducted by an expert panel (surgeons, palliative care physicians, nurses, and patients/caregivers). Among the 20 study patients, malignancy types included colorectal (n = 9), gastric (n = 4), urothelial/renal (n = 3), and other (n = 4), whereas sites of Obstruction were the small bowel (n = 11), gastric outlet (n = 3), and large bowel (n = 6). Thirteen patients (65%) had received chemotherapy within 6 weeks. Imaging evidence of a primary/recurrent tumor was documented in 13 patients (65%), carcinomatosis in 11 (55%), and ascites in 16 (80%). Thirty patient symptoms were identified on qualitative interviewing. Seven GIO-specific items were identified as relevant by the expert panel and will be added to the core symptom assessment inventory for further testing. We identified symptoms of importance that can be used to assess outcome after treatment of patients with advanced cancer and GIO. Testing for validity and reliability will be required before formal survey development.
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Selective Approach for Patients with Advanced Malignancy and Gastrointestinal Obstruction
Journal of the American College of Surgeons, 2017Co-Authors: Deep Pujara, Eduardo Bruera, Yi Ju Chiang, Janice N. Cormier, Brian BadgwellAbstract:Background The purpose of this study was to determine the frequency of tumor-related Gastrointestinal Obstruction and identify variables associated with functional outcomes and survival in patients with advanced malignancy and Gastrointestinal Obstruction. Study design We reviewed the medical records of 490 patients with advanced cancer, who underwent surgical consultation for Gastrointestinal Obstruction between January 2000 and May 2014. We used chi-square and logistic regression analyses to identify variables associated with survival and eating at discharge. Results Obstructions were tumor-related in 334 (68%) patients, adhesion-related in 96 (20%), and of unclear etiology in 60 (12%). The Obstruction site was the gastric outlet in 78 (16%), small bowel in 312 (64%), and large bowel in 100 (20%). Treatment was classified as medical (49% of patients), surgical (32%), and procedural (interventional radiology or endoscopy) (17%). Sixty-eight percent of patients were eating at the time of discharge, and 42% died within 90 days of surgical consultation. Median overall survival rates for patients managed with procedural, medical, and surgical treatment were 69, 135, and 314 days, respectively (p Conclusions Patients managed with surgery demonstrated improved survival on unadjusted analysis. However, on multivariate analysis that included the imaging extent of disease, surgery was not associated with outcome, which highlights the importance of patient selection and the need for additional research to identify variables critical for treatment selection.
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In search of the optimal outcome measure for patients with advanced cancer and Gastrointestinal Obstruction: A qualitative research study.
Journal of Clinical Oncology, 2016Co-Authors: Brian Badgwell, Loretta A Williams, Eduardo BrueraAbstract:100 Background: Gastrointestinal Obstruction (GIO) is the most common indication for palliative surgical consultation in patients with advanced cancer. The purpose of this study was to delineate the symptom burden and experience of patients with GIO. Methods: Twenty patients with advanced cancer and GIO described symptoms at the time of surgical consultation. We used content analysis of interview transcripts and symptoms were ranked by frequency and compared to a general symptom assessment survey (MD Anderson Symptom Inventory). Results: Malignancy type included colorectal (N = 9), gastric (N = 4), urothelial/renal (N = 3), and other (N = 4), while site of Obstruction was small bowel in 11 (55%), gastric outlet in 3 (15%), and large bowel in 6 (30%). Thirteen patients (65%) had received chemotherapy within 6 weeks. Imaging evidence of a primary/recurrent tumor, carcinomatosis, or ascites was documented in 13 (65%), 11 (55%), and 16 (80%) patients, respectively. Thirty symptoms were identified on qualitati...
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Outcome Measures Other than Morbidity and Mortality for Patients with Incurable Cancer and Gastrointestinal Obstruction
Journal of palliative medicine, 2013Co-Authors: Brian Badgwell, Robert S. Krouse, Suzanne Klimberg, Eduardo BrueraAbstract:Abstract Objective: To prospectively evaluate outcome measures of patients undergoing palliative surgical evaluation for Gastrointestinal Obstruction. Methods: Patients with an incurable malignancy undergoing consultation for Gastrointestinal Obstruction were prospectively enrolled from November 2009 to July 2012. We evaluated two patient-reported outcome measures of quality of life (Functional Assessment of Cancer Therapy-General [FACT-G]) and treatment satisfaction (Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-General Version 1 [FACIT-TS-G]) and five observational outcome measures (symptom improvement, 30 “good days,” ability to tolerate diet at discharge, discharge home, and death within 90 days). Results: Of 53 patients enrolled, 13 had gastric outlet Obstruction, 22 had small bowel Obstruction, and 18 had large bowel Obstruction. Patient-reported measures could not be analyzed because only 19 patients (36%) completed the FACT-G and FACIT-TS-G survey at 1-month follow-up. Ho...
M. E. C. Bakker - One of the best experts on this subject based on the ideXlab platform.
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Superior mesenteric artery syndrome in a 15-year-old boy during Ramadan.
European journal of pediatrics, 2013Co-Authors: M. E. C. Bakker, R. Van Delft, N. A. L. Vaessens, P. R. R. RosiasAbstract:A previously healthy 15-year-old boy who participated in Ramadan and recently suffered from a gastro-enteritis presented at the emergency room with abdominal pain, vomiting, and marked weight loss. Abdominal X-ray and computed tomography showed upper Gastrointestinal Obstruction and narrowing of the distance between superior mesenteric artery and aorta abdominalis. Through these findings, superior mesenteric artery syndrome was diagnosed. Treatment consisted of placement of a nasojejunal tube for enteral feeding until weight gain was substantial. Superior mesenteric artery syndrome is rare, with a prevalence varying between 0.013 and 0.3 %. It is characterized by compression of the third part of duodenum between aorta and superior mesenteric artery, thus causing signs and symptoms of upper Gastrointestinal Obstruction. Conclusion: In general, when signs and symptoms of upper Gastrointestinal Obstruction are accompanied with rapid weight loss, superior mesenteric artery syndrome should be considered.
Dimosthenis Kakaviatos - One of the best experts on this subject based on the ideXlab platform.
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Superior mesenteric artery syndrome: a rare case of upper Gastrointestinal Obstruction
Journal of surgical case reports, 2019Co-Authors: Dimosthenis Chrysikos, Theodore Troupis, John Tsiaoussis, Markos Sgantzos, Vasileios Bonatsos, Vasileios Karampelias, Theodoros Piperos, Vasileios Kalles, Panagiotis Theodoropoulos, Dimosthenis KakaviatosAbstract:Superior mesenteric artery (SMA) or Wilkie's syndrome is a rare clinical entity of partial or complete duodenal Obstruction. The pathogenic mechanism is an acute angulation of the SMA which leads to compression of the third part of the duodenum between the SMA and the aorta. This is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions. Its treatment is initially conservative and in case of failure, surgical therapy is unavoidable. We present a case of a 68-year-old female patient who presented in our Department with symptoms of dehydration after persistent vomiting for months. After complete radiologic workup, SMA syndrome was diagnosed and was successfully treated operatively. SMA syndrome might be a diagnostic challenge and must be always included in the differential diagnosis of upper Gastrointestinal Obstruction. Consequently, this paper aims to increase the awareness of a rare entity of duodenal Obstruction.
Yong Chan Lee - One of the best experts on this subject based on the ideXlab platform.
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ultrathin endoscope assisted self expandable metallic stent placement following initial unsuccessful attempt in malignant upper Gastrointestinal Obstruction
Digestive Endoscopy, 2014Co-Authors: Se Woo Park, Hyuk Lee, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan LeeAbstract:Background Conventional endoscopy for self-expandable metallic stent (SEMS) placement may be technically limited in long and tortuous strictures. Therefore, we analyzed the feasibility, safety and usefulness of ultrathin endoscopy (UTE)-guided SEMS placement. Patients and Methods This study involved 24 patients with upper Gastrointestinal Obstruction and unsuccessful initial attempts to place SEMS using conventional endoscopy. After completely passing a UTE across the stricture, the UTE was withdrawn, leaving a guidewire placed via the working channel. Through-the-scope SEMS placement was done using a conventional endoscope inserted along the guidewire. The primary endpoints were assessed by technical/clinical success and stent patency duration. Results Stents were successfully placed at target locations in all but one case with a long tortuous stricture, with 95.8% (23/24) technical success. One week after stent placement, mean gastricoutlet Obstruction score improved significantly from baseline (1.74 ± 0.62 and 0.33 ± 0.48, respectively; P < 0.001). Stent migration, restenosis, and fracture occurred in four (17.4%), six (26.1%), and one (4.3%) of 23 stents, respectively. Median stent patency duration was 79 days. Mean stent patency was significantly longer in patients who received palliative chemotherapy than in those who did not (122.9 ± 11.0 and 38.3 ± 4.6, respectively; P < 0.001). Conclusions UTE guidance SEMS delivery can be a feasible and safe rescue treatment method for malignant upper Gastrointestinal Obstruction in cases of failed attempts to place SEMS using conventional endoscopy. Our result warrants a further study to define the efficacy of this method in difficult SEMS placement cases.
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Ultrathin endoscope‐assisted self‐expandable metallic stent placement following initial unsuccessful attempt in malignant upper Gastrointestinal Obstruction
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2013Co-Authors: Woo Park, Hyuk Lee, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan LeeAbstract:Background Conventional endoscopy for self-expandable metallic stent (SEMS) placement may be technically limited in long and tortuous strictures. Therefore, we analyzed the feasibility, safety and usefulness of ultrathin endoscopy (UTE)-guided SEMS placement. Patients and Methods This study involved 24 patients with upper Gastrointestinal Obstruction and unsuccessful initial attempts to place SEMS using conventional endoscopy. After completely passing a UTE across the stricture, the UTE was withdrawn, leaving a guidewire placed via the working channel. Through-the-scope SEMS placement was done using a conventional endoscope inserted along the guidewire. The primary endpoints were assessed by technical/clinical success and stent patency duration. Results Stents were successfully placed at target locations in all but one case with a long tortuous stricture, with 95.8% (23/24) technical success. One week after stent placement, mean gastricoutlet Obstruction score improved significantly from baseline (1.74 ± 0.62 and 0.33 ± 0.48, respectively; P
