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Article ; Online: Volvulus of the Appendix.

Bhojwani, Deepika / Gourgiotis, Stavros / Simillis, Constantinos

2021 Volume 161, Issue 6, Page(s) 1809–1810

MeSH term(s)	Appendectomy ; Appendiceal Neoplasms/diagnostic imaging ; Appendiceal Neoplasms/pathology ; Appendiceal Neoplasms/surgery ; Appendix/blood supply ; Appendix/diagnostic imaging ; Appendix/pathology ; Appendix/surgery ; Cecal Diseases/diagnostic imaging ; Cecal Diseases/pathology ; Cecal Diseases/surgery ; Female ; Humans ; Intestinal Volvulus/diagnostic imaging ; Intestinal Volvulus/pathology ; Intestinal Volvulus/surgery ; Ischemia/diagnostic imaging ; Ischemia/pathology ; Ischemia/surgery ; Middle Aged ; Neoplasms, Cystic, Mucinous, and Serous/diagnostic imaging ; Neoplasms, Cystic, Mucinous, and Serous/pathology ; Neoplasms, Cystic, Mucinous, and Serous/surgery ; Predictive Value of Tests ; Tomography, X-Ray Computed ; Treatment Outcome
Language	English
Publishing date	2021-08-27
Publishing country	United States
Document type	Case Reports
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2021.08.038
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Article ; Online: Gastric volvulus causing liver ischemia.

Rooney, Siobhan / Stavrou, George / Sadler, Timothy J / Oikonomou, Ilias-Marios / Gourgiotis, Stavros

ANZ journal of surgery

2023 Volume 93, Issue 11, Page(s) 2776

MeSH term(s)	Humans ; Stomach Volvulus/diagnosis ; Stomach Volvulus/diagnostic imaging ; Liver Diseases/complications ; Liver Diseases/diagnostic imaging ; Ischemia/etiology
Language	English
Publishing date	2023-09-19
Publishing country	Australia
Document type	Letter
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.18702
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Article ; Online: Impact of penicillin allergy labels on surgical site infections in a large UK cohort of gastrointestinal surgery patients.

Jones, Nick K / Tom, Brian / Simillis, Constantinos / Bennet, John / Gourgiotis, Stavros / Griffin, Jo / Blaza, Helen / Nasser, Shuaib / Baker, Stephen / Gouliouris, Theodore

JAC-antimicrobial resistance

2024 Volume 6, Issue 1, Page(s) dlae022

Abstract: Objectives: Studies in the USA, Canada and France have reported higher surgical site infection (SSI) risk in patients with a penicillin allergy label (PAL). Here, we investigate the association between PALs and SSI in the UK, a country with distinct ... ...

Abstract	Objectives: Studies in the USA, Canada and France have reported higher surgical site infection (SSI) risk in patients with a penicillin allergy label (PAL). Here, we investigate the association between PALs and SSI in the UK, a country with distinct epidemiology of infecting pathogens and range of antimicrobial regimens in routine use. Methods: Electronic health records and national SSI surveillance data were collated for a retrospective cohort of gastrointestinal surgery patients at Cambridge University Hospitals NHS Foundation Trust from 1 January 2015 to 31 December 2021. Univariable and multivariable logistic regression were used to examine the effects of PALs and the use of non-β-lactam-based prophylaxis on likelihood of SSI, 30 day post-operative mortality, 7 day post-operative acute kidney injury and 60 day post-operative infection/colonization with antimicrobial-resistant bacteria or Results: Our data comprised 3644 patients and 4085 operations; 461 were undertaken in the presence of PALs (11.3%). SSI was detected after 435/4085 (10.7%) operations. Neither the presence of PALs, nor the use of non-β-lactam-based prophylaxis were found to be associated with SSI: adjusted OR (aOR) 0.90 (95% CI 0.65-1.25) and 1.20 (0.88-1.62), respectively. PALs were independently associated with increased odds of newly identified MRSA infection/colonization in the 60 days after surgery: aOR 2.71 (95% CI 1.13-6.49). Negative association was observed for newly identified infection/colonization with third-generation cephalosporin-resistant Gram-negative bacteria: aOR 0.38 (95% CI 0.16-0.89). Conclusions: No evidence was found for an association between PALs and the likelihood of SSI in this large UK cohort, suggesting significant international variation in the impact of PALs on surgical patients.
Language	English
Publishing date	2024-02-16
Publishing country	England
Document type	Journal Article
ISSN	2632-1823
ISSN (online)	2632-1823
DOI	10.1093/jacamr/dlae022
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Article ; Online: Diaphragm disease of the terminal ileum presenting as acute small bowel obstruction.

Bennett, Stephen / Martin, Jack / Mahler-Araujo, Betania / Gourgiotis, Stavros

BMJ case reports

2020 Volume 13, Issue 2

Abstract: Diaphragm disease (DD) of the small bowel is a rarely reported complication of non-steroidal anti-inflammatory drug (NSAID) use, characterised by diaphragm-like strictures, most commonly in the ileum, causing varying degrees of obstruction. It typically ... ...

Abstract	Diaphragm disease (DD) of the small bowel is a rarely reported complication of non-steroidal anti-inflammatory drug (NSAID) use, characterised by diaphragm-like strictures, most commonly in the ileum, causing varying degrees of obstruction. It typically presents in the elderly, over many years with non-specific symptoms. Diagnosis is challenging, the majority of cases relying on histopathology for confirmation. Treatment involves NSAID cessation and surgery through a combination of stricturoplasties and/or segmental resection. Very rarely DD presents as a surgical emergency. A case presenting as acute small bowel obstruction (SBO) is described, initially diagnosed as adhesions, later confirmed to be DD of the terminal ileum following histopathological examination. Given the widespread use of NSAIDs and an ageing population, it is likely the incidence of DD will increase. It is, therefore, important that surgeons are aware of this disease entity and consider it as a potential diagnosis in patients presenting with acute SBO.
MeSH term(s)	Acute Disease ; Aged ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Constriction ; Contrast Media ; Female ; Humans ; Intestinal Obstruction/etiology ; Intestine, Small/diagnostic imaging ; Intestine, Small/pathology ; Tissue Adhesions ; Tomography, X-Ray Computed
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal ; Contrast Media
Language	English
Publishing date	2020-02-06
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2019-233537
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Article ; Online: Spontaneous bowel perforation in the setting of colonic involvement with scleroderma.

Stupalkowska, Weronika / Mahler-Araujo, Betania / Bennett, John / Gourgiotis, Stavros

BMJ case reports

2020 Volume 13, Issue 1

Abstract: Here we present a rare case of spontaneous colonic perforation in a middle-aged woman affected by systemic sclerosis (SSc). In spite of maximal medical support and prompt emergency laparotomy for source control the patient died due to multiorgan failure ... ...

Abstract	Here we present a rare case of spontaneous colonic perforation in a middle-aged woman affected by systemic sclerosis (SSc). In spite of maximal medical support and prompt emergency laparotomy for source control the patient died due to multiorgan failure within 48 hours of admission. This case emphasises that although rarely, patients with scleroderma can present with colonic perforation which unfortunately due to their decreased physiological reserve, can lead to rapid and irreversible deterioration and subsequent death. It is therefore essential that clinicians faced with abdominal symptoms and signs in patients affected by SSc are able to quickly differentiate acute visceral perforation from benign causes.
MeSH term(s)	Fatal Outcome ; Female ; Humans ; Intestinal Perforation/etiology ; Intestinal Perforation/surgery ; Middle Aged ; Scleroderma, Systemic/complications ; Spontaneous Perforation/etiology ; Spontaneous Perforation/surgery
Language	English
Publishing date	2020-01-05
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2019-233220
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Article ; Online: Acute perforated appendicitis due to metastatic small-cell lung cancer.

Keramidaris, Dimitrios / Oikonomou, Christianna / Theodorolea, Kyriaki / Mohamed, Tahira / Gourgiotis, Stavros

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology

2019 Volume 30, Issue 11, Page(s) 993–994

MeSH term(s)	Acute Disease ; Aged ; Appendiceal Neoplasms/complications ; Appendiceal Neoplasms/secondary ; Appendicitis/etiology ; Humans ; Lung Neoplasms/complications ; Lung Neoplasms/pathology ; Male ; Small Cell Lung Carcinoma/complications ; Small Cell Lung Carcinoma/secondary
Language	English
Publishing date	2019-11-22
Publishing country	Turkey
Document type	Case Reports ; Letter
ZDB-ID	1340275-4
ISSN	2148-5607 ; 1300-4948
ISSN (online)	2148-5607
ISSN	1300-4948
DOI	10.5152/tjg.2018.18924
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Article: Fishbone perforation of the small bowel mimicking internal herniation and obstruction in a patient with previous gastric bypass surgery.

Traynor, Paul / Stupalkowska, Weronika / Mohamed, Tahira / Godfrey, Edmund / Bennett, John M H / Gourgiotis, Stavros

Journal of surgical case reports

2020 Volume 2020, Issue 9, Page(s) rjaa369

Abstract: Intestinal perforation following the ingestion of fishbone is unusual and rarely diagnosed preoperatively, as clinical and radiological findings are non-specific. We report a case of a female patient post Roux-en-Y gastric bypass (RYGBP) for obesity, who ...

Abstract	Intestinal perforation following the ingestion of fishbone is unusual and rarely diagnosed preoperatively, as clinical and radiological findings are non-specific. We report a case of a female patient post Roux-en-Y gastric bypass (RYGBP) for obesity, who presented with severe abdominal pain and guarding in left iliac fossa. Computed tomography (CT) suggested internal herniation with compromised vascular supply to the bowel. Exploratory laparotomy identified a perforation site in the blind loop of the RYGBP due to a protruding fishbone. After extraction, primary suture repair was performed. In retrospect, the fishbone was identified on CT but misinterpreted as suture line at the enteroenterostomy site. This case emphasizes that although rare, the ingestion of fishbone can lead to severe complications and should therefore be included in the differential for an acute abdomen. On CT, it should be noted that fishbone may simulate suture line within the bowel if the patient has history of previous surgery.
Language	English
Publishing date	2020-09-24
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjaa369
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Article ; Online: Delayed presentation of diaphragmatic rupture with stomach herniation and strangulation.

Falidas, Evangelos / Gourgiotis, Stavros / Vlachos, Konstantinos / Villias, Constantinos

The American journal of emergency medicine

2015 Volume 33, Issue 9, Page(s) 1329.e1–3

MeSH term(s)	Adult ; Delayed Diagnosis ; Hernia, Diaphragmatic, Traumatic/diagnosis ; Hernia, Diaphragmatic, Traumatic/etiology ; Hernia, Diaphragmatic, Traumatic/surgery ; Humans ; Male ; Rupture/diagnosis ; Rupture/etiology ; Rupture/surgery ; Wounds, Nonpenetrating/complications ; Wounds, Nonpenetrating/diagnosis ; Wounds, Nonpenetrating/surgery
Language	English
Publishing date	2015-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2015.02.052
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Article ; Online: Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon.

Anyomih, Theophilus Tk / Jennings, Thomas / Mehta, Alok / O'Neill, J Robert / Panagiotopoulou, Ioanna / Gourgiotis, Stavros / Tweedle, Elizabeth / Bennett, John / Davies, R Justin / Simillis, Constantinos

American journal of surgery

2022

Abstract: Background: Appendectomy is a benchmark operation for trainee progression, but this should be weighed against patient safety and perioperative outcomes.: Methods: Systematic literature review and meta-analysis comparing outcomes of appendectomy ... ...

Abstract	Background: Appendectomy is a benchmark operation for trainee progression, but this should be weighed against patient safety and perioperative outcomes. Methods: Systematic literature review and meta-analysis comparing outcomes of appendectomy performed by trainees versus trained surgeons. Results: Of 2086 articles screened, 29 studies reporting on 135,358 participants were analyzed. There was no difference in mortality (Odds ratio [OR] 1.08, P = 0.830), overall complications (OR 0.93, P = 0.51), or major complications (OR 0.56, P = 0.16). There was no difference in conversion from laparoscopic to open surgery (OR 0.81, P = 0.12) and in intraoperative blood loss (Mean Difference [MD] 5.58 mL, P = 0.25). Trainees had longer operating time (MD 7.61 min, P < 0.0001). Appendectomy by trainees resulted in shorter duration of hospital stay (MD 0.16 days, P = 0.005) and decreased reoperation rate (OR 0.78, P = 0.05). Conclusions: Appendectomy performed by trainees does not compromise patient safety. Due to statistical heterogeneity, further randomized controlled trials, with standardized reported outcomes, are required.
Language	English
Publishing date	2022-07-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2022.07.006
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Article ; Online: Systematic review and meta-analysis comparing perioperative outcomes of pediatric emergency appendicectomy performed by trainee vs trained surgeon.

Anyomih, Theophilus T K / Jennings, Thomas / Mehta, Alok / O'Neill, J Robert / Panagiotopoulou, Ioanna / Gourgiotis, Stavros / Tweedle, Elizabeth / Bennett, John / Davies, R Justin / Simillis, Constantinos

Pediatric surgery international

2022 Volume 38, Issue 9, Page(s) 1187–1196

Abstract: Appendicectomy is a common pediatric surgical procedure performed by trainees and surgeons with varying reported outcomes. It is a benchmark procedure for trainee progression and training benefits should be weighed against patient safety and ... ...

Abstract	Appendicectomy is a common pediatric surgical procedure performed by trainees and surgeons with varying reported outcomes. It is a benchmark procedure for trainee progression and training benefits should be weighed against patient safety and perioperative outcomes. This systematic review and meta-analysis investigated any differential perioperative outcomes dependent on the grade of the operating surgeon. A systematic literature review and meta-analysis were performed comparing outcomes of pediatric appendicectomy performed by trainees versus trained surgeons. Of 2,086 articles screened, 5 retrospective non-randomized comparative studies reporting on 10,019 participants were analyzed. There was no difference in overall complications (OR 0.92; 95% CI 0.76, 1.12; P = 0.42), major complications [Clavien-Dindo (CD) III/IV] (OR 1.18; 95% CI 0.71, 1.97; P = 0.52), minor complications (CD I/II) (OR 1.13; 95% CI 0.57, 2.27; P = 0.72), post-op ileus (OR 0.74; 95% CI 0.10, 5.26; P = 0.76), wound infections (OR 0.87; 95% CI 0.62, 1.21; P = 0.41), abscess formation (OR 0.58; 95% CI 0.28, 1.22; P = 0.15), operation times [Mean Difference (MD) 2.31 min; 95% CI - 4.94, 9.56; P = 0.53] and reoperation rate (OR 1.22; 95% CI 0.23, 6.42; P = 0.81). Trainees had fewer conversions to open appendicectomy (OR 0.14; 95% CI 0.02, 0.88; P = 0.04). Appendicectomy performed on pediatric patients by trainees did not compromise patient safety. LEVEL OF EVIDENCE: III.
MeSH term(s)	Appendectomy/methods ; Child ; Humans ; Laparoscopy/methods ; Operative Time ; Postoperative Complications/epidemiology ; Retrospective Studies ; Surgeons
Language	English
Publishing date	2022-07-20
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	632773-4
ISSN	1437-9813 ; 0179-0358
ISSN (online)	1437-9813
ISSN	0179-0358
DOI	10.1007/s00383-022-05160-9
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