Damage Control Surgery for Non‐traumatic Abdominal Emergencies

Girard, Édouard; Abba, J.; Boussat, Bastien; Trilling, Bertrand; Mancini, A.; Bouzat, Pierre; Létoublon, Christian; Chirica, Mircea; Arvieux, C.

doi:10.1007/s00268-017-4262-6

Cited by 47 publications

(38 citation statements)

References 59 publications

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“…4 When it comes to secondary cocoon due to Tb similar attempts may prove fatal as most patients were in poor nutritional status and present with peritonitis. 14,15 In these situations damage control surgery is done for a proximal diversion, laparostomy and biopsy which will relieve symptoms and provide diagnosis. Once treatment initiated (ATT) and nutritional build up achieved a definitive surgery can be planned later on.…”

Section: Discussionmentioning

confidence: 99%

Primary and secondary abdominal cocoon- diagnostic and management challenges: retrospective study

et al. 2019

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Background: Abdominal cocoon is a rare cause of intestinal obstruction characterized by fibro collagenous membrane encapsulating the abdominal contents to varying degrees. The most commonly identified etiology remains to be ‘idiopathic’ and hence it is also known as idiopathic sclerosing encapsulating peritonitis.. Few case reports of abdominal cocoon secondary to gastrointestinal malignancy and tuberculosis have also been reported. The objective of the study was to study the spectrum of clinical presentation, identify the various aetio pathogenesis described and their impact on outcome of surgically managed patients with abdominal cocoon.Methods: The clinical data of twelve different cases of abdominal cocoon presented to a general surgery unit from January 2012 to December 2017 with minimum of 1 year follow up were analyzed.Results: In our series we had 12 patients with cocoon who underwent surgical intervention out of which 8 were primary and 4 were secondary to TB. In primary type one out of eight patients had acute presentation, but in secondary three out of four had acute presentation. In primary 6 out of 7 patient’s pre-operative CT showed cocoon, but in secondary only 1 out of 3 showed cocoon. In patients with primary cocoon 3 out of 8 patients had bowel resection and only one had post-operative morbidity. In patients with secondary cocoon three patients had bowel resection, stoma creation and reoperations with stormy post operative period. All 4 had post-operative morbidity, however all of them received ATT and definitive surgery was performed 1-2 years later with minimal resection and serial images also showed resolution of cocoon formation with ATT. Primary group up to 5 years follow up, there was no recurrence of symptoms. Both groups did not have any mortality.Conclusions: Abdominal cocoon is a rare disorder and the cause may be primary or secondary. In our series tuberculosis is the aetiology for secondary cocoon. Primary cocoon is easier to diagnose, manage and associated with less post operative complications compare to secondary cocoon. Damage control first surgery, nutritional build up and treatment with anti tubercular drugs are needed for management of cocoon secondary to TB for a better outcome in acute presentations. Definitive surgery can be performed once the nutritional status improves with less morbidity.

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Section: Discussionmentioning

confidence: 99%

Primary and secondary abdominal cocoon- diagnostic and management challenges: retrospective study

et al. 2019

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“…Interestingly, approximately 50% of patients with severe sepsis/septic shock in the "on-demand" re-laparotomy group, actually required re-exploration [54]. Unfortunately, the most recent study in our investigation involving 164 patients did not specify the type of damage control procedure employed in each case, despite being prospectively done [55].…”

Section: Use Of Damage Control Surgery In the Setting Of Peritonitismentioning

confidence: 94%

“Genuine” Damage Control Laparotomy in Peritonitis: A Twenty-Year Review

Rezende-Neto¹,

Rotstein²

2017

J Surg

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“…On behalf of the authors, we appreciate the careful review of our report titled "Retrograde open mesenteric stenting should be considered as the initial approach to acute mesenteric ischemia" 1 by Abdallah et al We appreciate that Abdallah et al agree that retrograde open mesenteric stenting (ROMS) procedures should play an important role in the treatment of acute mesenteric ischemia. We concur with the criticism by Abdallah et al of our study, which was limited by a lack of power and bias owing to its retrospective nature, as we indicated in the last paragraph of our report.…”

Section: Replymentioning

confidence: 99%