RESUMO
Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.
Assuntos
Serviços Médicos de Emergência/métodos , Guias como Assunto , Hérnia Abdominal/cirurgia , Parede Abdominal/cirurgia , Gerenciamento Clínico , Serviços Médicos de Emergência/tendências , Humanos , Polipropilenos/uso terapêutico , Telas Cirúrgicas/tendências , Resultado do TratamentoRESUMO
INTRODUCTION: Groin lipoma is a rare condition. Such localization may lead to erroneous interpretation of inguinal hernia diagnosis. In case of incorrect diagnosis, there is clinically high risk for development of intraoperative complications. METHODS: The medical history of 70-year old female patient P., who has been hospitalized at Surgical Department No.1 of Danylo Halytsky Lviv National Medical University (Surgical Department of Lviv Regional Clinical Hospital), was processed retrospectively. RESULT: Medical case history totals approximately 20 years. Examination in the right groin revealed a tumor falling to the right labia lip: soft, elastic, moderately painful, passive and active reduction into the abdominal cavity was impossible, and the "cough impulse" symptom was negative. CT correctly diagnosed giant right groin lipoma, which was intraoperatively confirmed. CONCLUSION: Lipoma in the groin may be treated as inguinal hernia. Thus, for the accurate verification of correct diagnosis, it is necessary to perform a follow-up examination involving computer tomography (CT) and nuclear magnetic resonance imaging (NMRI).
RESUMO
Although sepsis is a systemic process, the pathophysiological cascade of events may vary from region to region.Abdominal sepsis represents the host's systemic inflammatory response to bacterial peritonitis.It is associated with significant morbidity and mortality rates, and is the second most common cause of sepsis-related mortality in the intensive care unit.The review focuses on sepsis in the specific setting of severe peritonitis.
RESUMO
Skin and soft tissue infections (SSTIs) encompass a variety of pathological conditions ranging from simple superficial infections to severe necrotizing soft tissue infections. Necrotizing soft tissue infections (NSTIs) are potentially life-threatening infections of any layer of the soft tissue compartment associated with widespread necrosis and systemic toxicity. Successful management of NSTIs involves prompt recognition, timely surgical debridement or drainage, resuscitation and appropriate antibiotic therapy. A worldwide international panel of experts developed evidence-based guidelines for management of soft tissue infections. The multifaceted nature of these infections has led to a collaboration among surgeons, intensive care and infectious diseases specialists, who have shared these guidelines, implementing clinical practice recommendations.
RESUMO
Emergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications.A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergency Surgery with the goal of defining recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel.