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  1. Article: Rare but relevant: a systematic review of stercoral perforation.

    Fernando, Sherwin / Sarma, Diwakar R

    British journal of hospital medicine (London, England : 2005)

    2021  Volume 82, Issue 4, Page(s) 1–7

    Abstract: Background/aims: Knowledge of the aetiologies of large bowel perforation are fundamental to its management. Stercoral perforation is a rare cause associated with high mortality. Owing to the paucity of coverage of this condition in the literature, this ... ...

    Abstract Background/aims: Knowledge of the aetiologies of large bowel perforation are fundamental to its management. Stercoral perforation is a rare cause associated with high mortality. Owing to the paucity of coverage of this condition in the literature, this review raises awareness of stercoral perforation among clinicians.
    Method: A literature search of PubMed, Embase, MEDLINE, CINAHL, Ovid and Cochrane was performed. Key search terms included 'stercoral, perforation', 'perforated', 'perforat*' and 'stercoral perforation'. Only literature published between December 2011 and July 2020 was included to avoid duplication.
    Results: Twenty-nine papers were obtained giving an overall cohort of 58 patients. The median age was 58 years (range 2-83 years) and 72.4% (
    Conclusions: The median age of patients with stercoral perforation has decreased from that found in previous studies and the mortality rate has improved. Chronic opioid users have also emerged as an important cohort. Early recognition, diligent decision making and focused perioperative care form the backbone of the definitive management of stercoral perforation.
    Language English
    Publishing date 2021-04-27
    Publishing country England
    Document type Journal Article
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2020.0659
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Diaphragm disease in emergency surgery.

    Sarma, Diwakar R / Bhattacharya, Pratik

    British journal of hospital medicine (London, England : 2005)

    2020  Volume 81, Issue 3, Page(s) 1–6

    Abstract: Background/aims: Diaphragm disease of the small bowel has been described in the literature over the last three decades. The pathognomonic characteristic of multiple circumferential stenosis is noted on gross examination of the bowel. It is a severe form ...

    Abstract Background/aims: Diaphragm disease of the small bowel has been described in the literature over the last three decades. The pathognomonic characteristic of multiple circumferential stenosis is noted on gross examination of the bowel. It is a severe form of non-steroidal anti-inflammatory drug-induced enteropathy, often presenting as acute small bowel obstruction. A systematic review was performed to identify risk factors and patient outcomes in histologically-proven diaphragm disease of the small intestine in patients undergoing emergency operation for small bowel obstruction.
    Methods: A comprehensive search was performed between January 1975 and March 2019 using relevant MeSH terms. Studies were chosen based on predefined inclusion criteria. Diaphragm disease of the small intestine was defined as macroscopically detected thin diaphragm-like mucosal folding inside the lumen of the bowel. The parameters assessed included patient characteristics, duration of use of non-steroidal anti-inflammatory drugs, type of emergency surgery performed, complications, recurrence, presentation and diagnosis of diaphragm disease.
    Results: A total of 21 studies were analysed which included 17 case reports, one case series, and three retrospective comparative studies. Overall 29 patients with diaphragm disease of the small bowel were reported following emergency laparotomy for small bowel obstruction. Use of non-steroidal anti-inflammatory drugs was noted in all cases with an average duration of 3-5 years. All patients presented acutely with features of small bowel obstruction and had emergency laparotomy, except one who underwent laparoscopic resection. In the comparative studies patients were more likely to be female and to have been taking non-steroidal anti-inflammatory drugs for more than 7 years.
    Conclusions: This is a rare disease, difficult to diagnose and often confirmed by the intra-operative macroscopic appearance of circumferential stenosis of the bowel. Risk factors for developing small bowel diaphragm disease include long-term use of non-steroidal anti-inflammatory drugs, and female gender. Patients with this disease are at increased risk of developing acute small bowel obstruction, so early identification is important.
    MeSH term(s) Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Emergencies ; Humans ; Intestinal Obstruction/chemically induced ; Intestinal Obstruction/diagnosis ; Intestinal Obstruction/surgery ; Intestine, Small/pathology ; Intestine, Small/surgery ; Postoperative Complications/epidemiology ; Risk Factors
    Chemical Substances Anti-Inflammatory Agents, Non-Steroidal
    Language English
    Publishing date 2020-03-11
    Publishing country England
    Document type Journal Article ; Systematic Review
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2019.0409
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Beware the distended appendix: technical adaptations to an appendicectomy when an appendiceal neoplasm is suspected.

    Arambepola, Devika / Jawaheer, Aminah I / Sarma, Diwakar R / Marriott, Paul / Charalampakis, Vasileios

    British journal of hospital medicine (London, England : 2005)

    2022  Volume 83, Issue 11, Page(s) 1–4

    MeSH term(s) Humans ; Appendix/surgery ; Appendiceal Neoplasms/surgery ; Appendectomy
    Language English
    Publishing date 2022-11-15
    Publishing country England
    Document type Journal Article
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2022.0233
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Penetrating Injury to the Gallbladder by a Needle Fish.

    Sarma, Diwakar R / Jeyasekharan, Sabu S

    The Indian journal of surgery

    2016  Volume 78, Issue 2, Page(s) 147–148

    Abstract: Penetrating abdominal trauma is a major killer worldwide. Various modes and mechanisms of injury have been described in world literature. We describe an unusual case of penetrating intra-abdominal injury caused by a 2-ft-long needle fish at sea. The mode ...

    Abstract Penetrating abdominal trauma is a major killer worldwide. Various modes and mechanisms of injury have been described in world literature. We describe an unusual case of penetrating intra-abdominal injury caused by a 2-ft-long needle fish at sea. The mode and mechanism of injury is rare and the consequences life threatening. There is paucity in the literature of such trauma and its presentation. This case report describes injury sustained by a fisherman at sea by a needle fish, causing biliary peritonitis from an isolated penetrating injury to the gallbladder. Typically, these fishes are known to jump up to 6 ft above the surface of the water and are voracious carnivores, feeding on smaller fishes in deep sea. The fisherman, having sustained the injury, had blood tinged bile oozing from the wound and attended casualty in severe abdominal pain and nausea. Diagnosis was prompt, and even though the presentation to the casualty was delayed, immediate resuscitative measures and surgery ensured successful management of the patient.
    Language English
    Publishing date 2016-04
    Publishing country India
    Document type Journal Article
    ZDB-ID 138063-1
    ISSN 0972-2068 ; 0019-5650
    ISSN 0972-2068 ; 0019-5650
    DOI 10.1007/s12262-015-1378-5
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 334: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  5. Article: Obscure intra-abdominal bleeding.

    Sarma, Diwakar R / Mclachlan, Greta

    British journal of hospital medicine (London, England : 2005)

    2015  Volume 76, Issue 10, Page(s) 607

    MeSH term(s) Aged ; Anticoagulants/adverse effects ; Atrial Fibrillation/drug therapy ; Female ; Frail Elderly ; Hematoma/chemically induced ; Hematoma/diagnostic imaging ; Hemorrhage/chemically induced ; Hemorrhage/diagnostic imaging ; Heparin, Low-Molecular-Weight/adverse effects ; Humans ; Radiography ; Retroperitoneal Space/diagnostic imaging
    Chemical Substances Anticoagulants ; Heparin, Low-Molecular-Weight
    Language English
    Publishing date 2015-10
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2015.76.10.607
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Spontaneous rupture of the urinary bladder.

    Sarma, Diwakar R / John, Ajo

    British journal of hospital medicine (London, England : 2005)

    2015  Volume 76, Issue 7, Page(s) 427

    MeSH term(s) Aged, 80 and over ; Humans ; Male ; Radiography ; Rupture, Spontaneous ; Urinary Bladder Diseases/diagnosis ; Urinary Bladder Diseases/diagnostic imaging
    Language English
    Publishing date 2015-07
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2015.76.7.427
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Stomal metastasis of colorectal cancer.

    Sarma, Diwakar R / Alvi, Ali

    British journal of hospital medicine (London, England : 2005)

    2015  Volume 76, Issue 11, Page(s) 665

    MeSH term(s) Adenocarcinoma/secondary ; Adenocarcinoma/therapy ; Aged ; Female ; Humans ; Sigmoid Neoplasms/pathology ; Sigmoid Neoplasms/surgery ; Surgical Stomas/pathology
    Language English
    Publishing date 2015-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2015.76.11.665
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study.

    Younus, Hafsa / Chakravartty, Saurav / Sarma, Diwakar R / Patel, Ameet G

    Obesity surgery

    2018  Volume 28, Issue 10, Page(s) 3020–3027

    Abstract: Background: Obesity surgery mortality risk scoring system (OS-MRS) classifies patients into high, intermediate and low risk, based on age, body mass index, sex and other comorbidities such as hypertension and history of pulmonary embolism. High-risk ... ...

    Abstract Background: Obesity surgery mortality risk scoring system (OS-MRS) classifies patients into high, intermediate and low risk, based on age, body mass index, sex and other comorbidities such as hypertension and history of pulmonary embolism. High-risk patients not only have a higher mortality but are more likely to develop post-operative complications necessitating intervention or prolonged hospital stay following bariatric surgery. Endoscopically placed duodenal-jejunal bypass sleeve (Endobarrier) has been designed to achieve weight loss and improve glycaemic control in morbidly obese patients with clinically proven effectiveness. The aim of this study was to assess if pre-operative insertion of endobarrier in high-risk patients can decrease morbidity and length of stay after bariatric surgery.
    Materials and methods: Between 2012 and 2014, a cohort of 11 high-risk patients had an Endobarrier inserted (E&BS group) for 1 year prior to definitive bariatric surgery. These patients were compared against a similar group undergoing primary bariatric surgery (PBS group) during same duration. The two groups were matched for age, gender, body mass index, comorbidities, surgical procedure and OS-MRS using propensity score matching. Outcome measures included operative time, morbidity, length of stay, intensive therapy unit (ITU) stay, readmission rate, percentage excess weight loss (%EWL) and percentage total weight loss (%TWL).
    Results: Patient characteristics and OS-MRS were similar in both groups (match tolerance 0.1). There was no significant difference in total length of stay, readmission rate, %EWL and %TWL. Operative time, ITU stay, post-operative complications and severity of complications were significantly less in the E&BS group (p < 0.05) with significant likelihood of planned ITU admissions in the PBS group (p < 0.05).
    Conclusion: Endobarrier could be considered as a pre bariatric surgical intervention in high-risk patients. It may result in improved post-operative outcomes in high-risk bariatric patients.
    MeSH term(s) Bariatric Surgery/adverse effects ; Bariatric Surgery/instrumentation ; Bariatric Surgery/statistics & numerical data ; Duodenum/physiology ; Feasibility Studies ; Humans ; Jejunum/physiology ; Length of Stay ; Obesity, Morbid/surgery ; Operative Time ; Postoperative Complications
    Language English
    Publishing date 2018-06-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-018-3322-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3381: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Colonic tuberculosis masquerading as colorectal malignancy.

    Sarma, Diwakar R / Thebe, Phauda R / Bhardwaj, Rakesh

    International journal of colorectal disease

    2015  Volume 30, Issue 7, Page(s) 997–998

    MeSH term(s) Aged ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/diagnostic imaging ; Diagnosis, Differential ; Humans ; Male ; Radiography ; Tuberculosis/diagnosis ; Tuberculosis/diagnostic imaging
    Language English
    Publishing date 2015-07
    Publishing country Germany
    Document type Case Reports ; Letter
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-014-2092-7
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2121: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  10. Article ; Online: Staple Line Bleeding in Sleeve Gastrectomy-a Simple and Cost-Effective Solution.

    Chakravartty, Saurav / Sarma, Diwakar R / Chang, Avril / Patel, Ameet G

    Obesity surgery

    2016  Volume 26, Issue 7, Page(s) 1422–1428

    Abstract: Background: Staple line bleeding (SLB) is a common intraoperative complication following resection in laparoscopic sleeve gastrectomy (SG). Opinion is divided on the best measure to deal with SLB which includes expensive reinforcement strategies, ... ...

    Abstract Background: Staple line bleeding (SLB) is a common intraoperative complication following resection in laparoscopic sleeve gastrectomy (SG). Opinion is divided on the best measure to deal with SLB which includes expensive reinforcement strategies, suturing the staple line or diathermy. Tranexemic acid is a relatively inexpensive drug known to reduce bleeding in trauma and surgery. The aim of this study was to evaluate whether intraoperative tranexemic acid reduces staple line bleeding.
    Methods: In this prospective matched comparative study of SG, one cohort of patients was administered tranexemic acid (1 g) after induction and compared to a control group. The primary outcome compared the number of staple line bleeding points requiring intervention intra-operatively. Secondary outcomes included estimated blood loss and operating time. The anaesthetic and thromboprophylaxis protocols were uniform. Operative technique and stapling equipment were identical in all patients.
    Results: Twenty-five patients were allocated to both the control and treatment arms. Patient characteristics in both groups were similar in age (median 34 vs 43 years), body mass index (median 54.7 vs 52 kg/m(2)), gender distribution (female:male = 20:5) and co-morbidities. The treatment group receiving tranexemic acid, required significantly less number of haemostatic stitches for staple line bleeding (19 vs 46, p < 0.05), incurred less intraoperative blood loss (p < 0.01) and had quicker operating times (median 66 vs 80 min, p < 0.05). There was no difference in morbidity or mortality in both groups.
    Conclusion: Intraoperative prophylactic tranexemic acid use is a simple and economical option for effectively reducing staple line bleeds leading to significant decrease in operating times.
    Language English
    Publishing date 2016-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-015-1986-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3381: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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