Endoscopic vacuum therapy(EVT)is an increasingly popular treatment option for wall defects in the upper gastrointestinal tract.After its initial description for the treatment of anastomotic leaks after esophageal and ...Endoscopic vacuum therapy(EVT)is an increasingly popular treatment option for wall defects in the upper gastrointestinal tract.After its initial description for the treatment of anastomotic leaks after esophageal and gastric surgery,it was also implemented for a wide range of defects,including acute perforations,duodenal lesions,and postbariatric complications.Apart from the initially proposed handmade sponge inserted using the“piggyback”technique,further devices were used,such as the commercially available EsoSponge and VAC-Stent as well as open-pore film drainage.The reported pressure settings and intervals between the subsequent endoscopic procedures vary greatly,but all available evidence highlights the efficacy of EVT,with high success rates and low morbidity and mortality,so that in many centers it is considered to be a first-line treatment,especially for anastomotic leaks.展开更多
Enteric intussusception caused by primary intestinalmalignant melanoma is a very rare cause of intestinalobstruction.We herein present a case of a 42-yearold female patient with no prior medical history ofmalignant me...Enteric intussusception caused by primary intestinalmalignant melanoma is a very rare cause of intestinalobstruction.We herein present a case of a 42-yearold female patient with no prior medical history ofmalignant melanoma,who was admitted with persistentabdominal pain,nausea,and vomiting.A computedtomography scan revealed an intestinal obstruction dueto ileocolic intussusception.An emergency laparoscopy and subsequent laparotomy revealed multiple small solid tumors across the whole small bowel.An oncologic resection was not feasible due to the insufficient length of the remaining small bowel.Only a small segment of ileum,which included the largest tumors causing the intussusception,was resected.The pathologic examination revealed two intestinal malignant melanoma lesions.A systematic clinical examination,endoscopic procedures,and fluorodeoxyglucose positron emission tomography-computed tomography scan all failed to reveal any indication of cutaneous,anal,or retinal melanoma.Hence,the tumor was classified as a primary intestinal malignant melanoma with multiple intestinal metastases.Since a complete oncologic resection of tumors was not possible,in order to prevent future intestinal obstruction,a surgical resection of the largest lesions was performed with palliative intention.The epidemiology,clinical m a n i fe s t a t i o n s,d i a g n o s i s a n d m a n a g e m e n t o f primary intestinal malignant melanoma,and intestinal intussusception in adults are discussed along with a review of the current literature.展开更多
文摘Endoscopic vacuum therapy(EVT)is an increasingly popular treatment option for wall defects in the upper gastrointestinal tract.After its initial description for the treatment of anastomotic leaks after esophageal and gastric surgery,it was also implemented for a wide range of defects,including acute perforations,duodenal lesions,and postbariatric complications.Apart from the initially proposed handmade sponge inserted using the“piggyback”technique,further devices were used,such as the commercially available EsoSponge and VAC-Stent as well as open-pore film drainage.The reported pressure settings and intervals between the subsequent endoscopic procedures vary greatly,but all available evidence highlights the efficacy of EVT,with high success rates and low morbidity and mortality,so that in many centers it is considered to be a first-line treatment,especially for anastomotic leaks.
文摘Enteric intussusception caused by primary intestinalmalignant melanoma is a very rare cause of intestinalobstruction.We herein present a case of a 42-yearold female patient with no prior medical history ofmalignant melanoma,who was admitted with persistentabdominal pain,nausea,and vomiting.A computedtomography scan revealed an intestinal obstruction dueto ileocolic intussusception.An emergency laparoscopy and subsequent laparotomy revealed multiple small solid tumors across the whole small bowel.An oncologic resection was not feasible due to the insufficient length of the remaining small bowel.Only a small segment of ileum,which included the largest tumors causing the intussusception,was resected.The pathologic examination revealed two intestinal malignant melanoma lesions.A systematic clinical examination,endoscopic procedures,and fluorodeoxyglucose positron emission tomography-computed tomography scan all failed to reveal any indication of cutaneous,anal,or retinal melanoma.Hence,the tumor was classified as a primary intestinal malignant melanoma with multiple intestinal metastases.Since a complete oncologic resection of tumors was not possible,in order to prevent future intestinal obstruction,a surgical resection of the largest lesions was performed with palliative intention.The epidemiology,clinical m a n i fe s t a t i o n s,d i a g n o s i s a n d m a n a g e m e n t o f primary intestinal malignant melanoma,and intestinal intussusception in adults are discussed along with a review of the current literature.
