ARTERIAL THROMBOEMBOLIC COMPLICATIONS OF INFLAMMATORY BOWEL-DISEASE - REPORT OF 3 CASES
coagulation; crohns-disease; Gastroenterology & Hepatology; Surgery; ulcerative-colitis
Extraintestinal manifestations of inflammatory bowel disease are legion and are demonstrated in one-third of those afflicted. In general, they do not mandate surgery. Three patients with active pancolonic ulcerative colitis developed arterial thromboembolic complications prior to surgical treatment. Thromboembolic complications are not fully understood, as is evidenced by the paucity of information in the literature, and only sporadic cases of arterial thromboemboli are found. These have been described primarily in the postsurgical patient. To ascertain whether others have encountered similar cases, a survey form was distributed to members of The American Society of Colon and Rectal Surgeons, yielding an additional 54 patients with thromboembolic complications. Approximately two-thirds were deep venous thromboses and/or pulmonary emboli. Ten patients had cerebrovascular accidents, and eight had arterial emboli. Eleven patients, over 21 percent, suffered multiple events. There were four resultant mortalities. An arterial thromboembolic event in a patient with ulcerative colitis is usually associated with pancolonic disease, has a poor long-term prognosis, and is an indication for colectomy.
Novotny D A; Rubin R J; Slezak F A; Porter J A
Diseases of the Colon & Rectum
1992
1992-02
Journal Article
<a href="http://doi.org/10.1007/bf02050678" target="_blank" rel="noreferrer noopener">10.1007/bf02050678</a>
DELAYED PNEUMOTHORAX - A COMPLICATION OF SUBCLAVIAN VEIN CATHETERIZATION
Nutrition & Dietetics
Slezak F A; Williams G B
Journal of Parenteral and Enteral Nutrition
1984
1984
Journal Article
<a href="http://doi.org/10.1177/0148607184008005571" target="_blank" rel="noreferrer noopener">10.1177/0148607184008005571</a>
Delayed presentation of an inflammatory polyp following colonic ischemia.
Female; Humans; Time Factors; Aged; Colitis/*etiology/pathology/surgery; Colon/*blood supply; Colonic Polyps/diagnosis/*etiology/pathology/surgery; Colonoscopy; Ischemia/*complications
Inflammatory polyps are usually associated with inflammatory bowel disease. The majority of these lesions are asymptomatic, however, they may be a source of obstruction or hemorrhage. These polyps represent re-epithelialization of the damaged colonic mucosa. Although inflammatory polyps have been associated with the acute phase of ischemic colitis, there has been only one report of delayed presentation of a symptomatic inflammatory polyp following ischemic injury to the colon. We present the second such report and a review of the literature.
Pidala M J; Slezak F A; Hlivko T J
The American surgeon
1993
1993-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Management Of Premature Removal Of The Percutaneous Gastrostomy
Surgery
Galat S A; Gerig K D; Porter J A; Slezak F A
American Surgeon
1990
1990-11
Journal Article or Conference Abstract Publication
n/a
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY FOR GUNSHOT WOUNDS TO THE OROPHARYNX
Gastroenterology & Hepatology
Pigott J P; Slezak F A
Gastrointestinal Endoscopy
1987
1987-02
Journal Article
<a href="http://doi.org/10.1016/s0016-5107(87)71495-3" target="_blank" rel="noreferrer noopener">10.1016/s0016-5107(87)71495-3</a>
Predictive Factors For Early Mortality After Percutaneous Endoscopic Gastrostomy
aspiration pneumonia; complications; Gastroenterology & Hepatology; jejunostomy; risk; surgical gastrostomy; tube
Background: Percutaneous endoscopic gastrostomy (PEG) is a safe access procedure for enteral nutrition. The purpose of this investigation is to identify predictive factors for early mortality after PEG. Methods: A retrospective review of the hospital records of 416 patients undergoing PEG from June 1, 1989, through December 31, 1991, was conducted. Patient demographics, admitting diagnosis, indication for PEG, risk factors for early mortality, and cause and date of death were reviewed. Logistic regression analysis was used to develop a model to predict early mortality after PEG. The follow-up period ranged from 1 to 30 months. Results: The overall mortality rate in this review was 227 of 416 patients (54.6%). The 7- and 30-day case fatality rates were 39 of 416 (9.4%) and 97 of 416 (23.3%), respectively. Logistic regression analysis showed that urinary tract infection (odds ratio (OR) = 3.05; 95% confidence interval (CI) = 1.45 - 6.43) and previous aspiration (OR = 6.86; 95% CI = 3.27 - 14.4) were predictive factors for death at 1 week after PEG. Patients who had both risk factors had a 48.4% probability of dying within 7 days after PEG insertion, whereas those who had no risk factors had a 4.3% probability of death. Urinary tract infection (OR = 2.00; 95% CI = 1.17 - 3.41), previous aspiration (OR = 3.62; 95% CI = 2.00 - 6.55), and age greater than 75 years (OR = 2.49; 95% CI = 1.47 - 4.21) were predictive factors for death at 1 month after PEG. Patients who had all three risk factors had a 67.1% probability of death at 1 month while those who had no risk factors had a 10% probability of death. Conclusions: A subgroup of patients exists that has a very high mortality rate after PEG. Less invasive ways of nutritionally supporting these high-risk patients should be evaluated.
Light V L; Slezak F A; Porter J A; Gerson L W; McCord G
Gastrointestinal Endoscopy
1995
1995-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/s0016-5107(95)70132-x" target="_blank" rel="noreferrer noopener">10.1016/s0016-5107(95)70132-x</a>
Retroperitoneal Air After Routine Hemorrhoidectomy - Report Of A Case
Gastroenterology & Hepatology; Surgery
Kriss B D; Porter J A; Slezak F A
Diseases of the Colon & Rectum
1990
1990-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/bf02139108" target="_blank" rel="noreferrer noopener">10.1007/bf02139108</a>
Splenic rupture from colonoscopy. A report of two cases and review of the literature.
Colonoscopy/*adverse effects; Female; Follow-Up Studies; Humans; Middle Aged; Spleen/injuries; Splenectomy; Splenic Rupture/*etiology/surgery; Tomography; X-Ray Computed
Splenic injury after colonoscopy is rare. Only 15 cases previously have been reported in the English literature. Partial capsular avulsion is the proposed mechanism of injury. Any condition causing increased splenocolic adhesions may be a predisposing factor to splenic injury. Two cases of splenic injury following colonoscopy are reported in addition to a complete review of the literature.
Espinal E A; Hoak T; Porter J A; Slezak F A
Surgical endoscopy
1997
1997-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s004649900298" target="_blank" rel="noreferrer noopener">10.1007/s004649900298</a>
The Evolution Of Surgical Endoscopic Training - Meeting The American Board Of Surgery Requirements
fiberoptic endoscopy; program; residents; Surgery; university
Cullado M J; Porter J A; Slezak F A
American Surgeon
1991
1991-04
Journal Article or Conference Abstract Publication
n/a