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C.A. Bautista-López

Bio: C.A. Bautista-López is an academic researcher. The author has contributed to research in topics: Gallstone ileus & Hernia. The author has an hindex of 4, co-authored 7 publications receiving 89 citations.

Papers
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Journal ArticleDOI
TL;DR: The results of this review showed that gallstone ileus etiology was due to intestinal obstruction from a gallstone that migrated into the intestinal lumen through a bilioenteric fistula, and enterolithotomy was the recommended technique for management because of its lower morbidity and mortality than the other techniques.
Abstract: Introduction Gallstone ileus represents 4% of the causes of bowel obstruction in the general population, but increases to 25% in patients above the age of 65 years Gallstone ileus does not present with unique symptoms, making diagnosis difficult Its management is surgical, but there is no consensus as to which of the different surgical techniques is the procedure of choice At present, there is no recent review of this pathology Aim To conduct an up-to-date review of this disease Materials and methods Articles published within the time frame of 2000 to 2014 were found utilizing the PUBMED, EMBASE, and Cochrane Library search engines with the terms “gallstone ileus” plus “review” and the following filters: “review”, “full text”, and “humans” Results The results of this review showed that gallstone ileus etiology was due to intestinal obstruction from a gallstone that migrated into the intestinal lumen through a bilioenteric fistula The presence of 2 of the 3 Rigler's triad signs was considered diagnostic Abdominal tomography was the imaging study of choice for gallstone ileus diagnosis and the surgical procedures for management were enterolithotomy, one-stage surgery, and two-stage surgery Enterolithotomy had lower morbidity and mortality than the other 2 procedures Conclusions The aim of gallstone ileus treatment is to release the obstruction, which is done through enterolithotomy It is the recommended technique for gallstone ileus management because of its lower morbidity and mortality, compared with the other techniques

48 citations

Journal ArticleDOI
TL;DR: The case of a forty-year-old male patient with an incarcerated right side inguinal hernia is described, which demonstrates that this pathology must remain in the mind of the surgeons especially in the event of a strangulated hernia.
Abstract: Introduction Amyand Hernia is a rare disease seen in approximately 1% of all hernias, complications of it, like acute appendicitis, or perforated appendicitis are even more rare, about 0.1%. Its diagnosis is very difficult in the pre-operative period; it is usually an incidental finding.

46 citations

Journal ArticleDOI
TL;DR: Esta es the tecnica recomendada para el manejo del ileo biliar debido a su morbimortalidad menor, comparada with las otras tecnicas.
Abstract: Resumen Introduccion El ileo biliar representa el 4% de las causas de obstruccion intestinal en la poblacion general, pero incrementa a un 25% en los pacientes mayores a los 65 anos de edad. El ileo biliar no presenta sintomas unicos, haciendo dificil su diagnostico. Su manejo es quirurgico, pero no hay consenso sobre cual de las diferentes tecnicas quirurgicas es el procedimiento de eleccion. Actualmente, no hay una revision reciente de esta patologia. Objetivo Llevar a cabo una revision actualizada de esta enfermedad. Materiales y metodos Los articulos publicados dentro del periodo 2000-2014 se encontraron utilizando los motores de busqueda PUBMED, EMBASE, y la Cochrane Library utilizando los terminos «gallstone ileus» mas «review» y los siguientes filtros fueron empleados: «review», «full text», y «humans». Resultados Los resultados de esta revision mostraron que la etiologia del ileo biliar se debio a la obstruccion intestinal ocasionada por un calculo biliar que migro hacia el lumen intestinal a traves de una fistula enterobiliar. La presencia de 2 de los 3 signos de la triada de Rigler se considero al momento de diagnostico. La tomografia abdominal fue el estudio de eleccion para el diagnostico del ileo biliar y los procedimientos quirurgicos para su manejo fueron la enterolitotomia, la cirugia en un solo tiempo, y la cirugia en dos tiempos. La enterolitotomia tenia una morbimortalidad menor que los otros dos procedimientos. Conclusiones El objetivo del tratamiento del ileo biliar es liberar la obstruccion, obtenido a traves de la enterolitotomia. Esta es la tecnica recomendada para el manejo del ileo biliar debido a su morbimortalidad menor, comparada con las otras tecnicas.

32 citations

Journal ArticleDOI
TL;DR: The Sandwich technique has demonstrated good outcomes in the management of the Grynfelt-Lesshaft's hernia and should be according to the classification proposed and to the experience of the surgeon.
Abstract: Introduction Lumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life. Case report A 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type “A” lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO® mesh fixed with PDS® II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication. Discussion Primary (spontaneous) lumbar hernias represent 50–60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH. Conclusion The surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.

15 citations

Journal ArticleDOI
TL;DR: This work presents a small approach to the gallstone ileus physiopathology of Karewsky syndrome and demonstrates that enterolithotomy approach is an efficient procedure in this pathology.

3 citations


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Journal ArticleDOI
TL;DR: It is concluded that although an effective first-line tool, plain abdominal films are not adequate for diagnosing gallstone ileus, and the gold standard in an acutely unwell patient is computed tomography.
Abstract: Gallstone ileus is a rare cause of bowel obstruction, which mainly affects the elderly population. The associated mortality is estimated to be up to 30%. The presentation of gallstone ileus is notoriously non-specific, and this often contributes to the delay in diagnosis. The diagnosis of gallstone ileus relies on a radiological approach, and herein we discuss the benefits and drawbacks of the use of different modalities of radiological imaging: plain abdominal films, computed tomography, magnetic resonance imaging, and ultrasound scanning. Based on our case experience and review of the literature, the authors conclude that although an effective first-line tool, plain abdominal films are not adequate for diagnosing gallstone ileus. In fact, the gold standard in an acutely unwell patient is computed tomography.

61 citations

Journal ArticleDOI
TL;DR: A patient with a history of abdominopelvic surgery along with one or more cardinal features of obstruction should be suspected to have ASBO until proven otherwise and proceed with surgery if symptoms of bowel compromise are present, or if symptoms do not resolve or have worsened.
Abstract: Small bowel obstruction (SBO) accounts for 12-16% of emergency surgical admissions and 20% of emergency surgical procedures. Even with the advent of laparoscopic surgery, intra-abdominal adhesions remain a significant cause of SBO, accounting for 65% of cases. History and physical examination are essential to identify signs of bowel ischemia as this indicates a need for urgent surgical exploration. Another critical aspect of evaluation includes establishing the underlying cause for obstruction and distinguishing between adhesive and non-adhesive etiologies as adhesive SBO (ASBO) can be managed non-operatively in 70-90% of patients. A patient with a history of abdominopelvic surgery along with one or more cardinal features of obstruction should be suspected to have ASBO until proven otherwise. Triad of severe pain, pain out of proportion to the clinical findings, and presence of an abdominal scar suggest possible closed-loop obstruction. Computed tomography has higher sensitivity and specificity compared to plain films and is recommended by the Bologna guidelines. Correcting fluid and electrolyte imbalance is an initial crucial step to mitigate severe hypovolemia. Patients should proceed with surgery if symptoms of bowel compromise are present, or if symptoms do not resolve or have worsened. Surgery is indicated in patients with ischemia, strangulation, perforation, peritonitis, or failure of non-operative treatment. With advances in minimal access technology and increasing experience, laparoscopic adhesiolysis is recommended. Mechanical adhesion barriers are an effective measure to prevent adhesion formation.

35 citations

Journal ArticleDOI
TL;DR: This review study aims to describe the pathophysiology of inflammation of the appendix - contained in the hernia sac - and present the latest data about the diagnostic approach and surgical treatment of Amyand's hernia.
Abstract: Amyand's hernia is defined as an inguinal hernia, containing the appendix within the hernia sac. Incidence of this rare condition rises up to 1% (0.19-1.7%) of all inguinal hernia cases. Inflammation of the appendix within the inguinal sac is even rarer, as it corresponds to 0.1% (0.07-0.13%) of all Amyand's hernia cases. After a comprehensive review of the limited relevant literature, we aim through this review study to describe the pathophysiology of inflammation of the appendix - contained in the hernia sac - and present the latest data about the diagnostic approach and surgical treatment of Amyand's hernia.

34 citations

Journal ArticleDOI
TL;DR: It may be beneficial for patients with type 2 Amyand’s hernia to have an appendectomy with a tension free hernia repair using mesh, according to this study.

20 citations

Journal ArticleDOI
TL;DR: It is shown that minimally invasive treatment such as colonoscopy or laparoscopy is possible in these cases of gallstone ileus, a rare and difficult-to-diagnose condition.
Abstract: Background: Gallstone or biliary ileus is a late complication of gallstone disease. It accounts for 1%–4% of all bowel obstructions and is more common in elderly patients. The preferred treatment option is to mechanically remove the impacted stones. It is done surgically using open or laparoscopic approach and rarely, when stones are impacted in the colon, endoscopically. In this paper we present five consecutive cases of gallstone ileus and describe possible diagnostic and minimally invasive treatment options. Case presentation: During a five-month period a total of five patients were treated for gallstone ileus. All patients were female and from 48 to 87 years of age. Symptoms were not specific and common for all small bowel obstructions. Upon admission the patients also had unspecific laboratory findings—neutrophilic leukocytosis and various C-reactive protein concentrations, ranging from 8 to 347 mg/L. According to the hospital protocol, all patients initially underwent an abdominal ultrasound, which was inconclusive, and therefore every patient additionally had a CT scan with intravenous contrast. After these two diagnostic modalities one patient still did not have the definitive gallstone ileus diagnosis, as the ectopic stone was not visible. Four patients in our case series were treated using minimally invasive methods: in one case the stone was removed endoscopically, and laparoscopically in the other three. Treatment outcomes were good in four cases as the patients fully recovered, however one patient suffered a massive cerebral infarction after the operation and passed away. Conclusions: Gallstone ileus is a rare and difficult-to-diagnose condition. Management of these patients in every case should be individualized, as there are many options, each with their own advantages and disadvantages. We show that minimally invasive treatment such as colonoscopy or laparoscopy is possible in these cases.

17 citations