Digestive surgery service including surgical management of gastrointestinal disease and digestive cancers are experiencing the impact of COVID-19 pandemic. Therefore it is necessary to formulate recommendation for digestives surgery service, as guidelines to engage in case-by-case assessment of particular patients with digestive diseases. We are aware that the knowledge and science of COVID-19 are still evolving, with new progression every day. This recommendation reflect actual condition and are subject for future adjustment in the future.
Background: Every 1 person out of 3 people with obstructive jaundice will die from complications of obstructive jaundice. The absence of bile salts causes the loss of the protective layer of the intestinal mucosa, which causes an increase in the permeability of the intestinal wall, triggering the process of translocation of various bacteria from the intestinal tract to the blood circulation so that it can trigger septicemia and sepsis. Dadih or commonly known as ampiang dadih is a fermented buffalo milk product. Dadih contains lactic acid bacteria microbiota, which can function as probiotics fermented milk starter Lactococcus lactis D4 dadih to small intestine in obstructive jaundice in vivo.
Methods: This study was an in vivo experimental study using 30 wistar rats, which were divided into 3 test groups. Observation of the condition of the small intestine was carried out histopathologically to assess the inflammatory process and the condition of the intestinal mucosa. Data analysis was performed using SPSS version 25 using univariate and bivariate methods.
Results: Group 3 showed minimal histopathological inflammation compared to the control and was statistically different, p<0.05.
Conclusion: Giving fermented milk starter Lactococcus lactis D4 dadih was able to reduce the inflammatory response and repair the intestinal mucosa in conditions of obstructive jaundice in vivo studies.
Introduction
During the coronavirus disease 2019 (COVID‐19) pandemic, digestive surgery potentially exposes both health‐care professionals and vulnerable patients to COVID‐19. A survey was conducted with aim to determine the digestive surgery services provided during the COVID‐19 pandemic, optimize safety for patients and clinicians, and safeguard health‐care services.
Methods
An online survey was conceived and circulated to members of the Indonesian Society of Digestive Surgeons. The survey was conducted in two phases, in April 2020 and July 2020, to evaluate changes in response to the COVID‐19 pandemic.
Results
Early in the pandemic (April 2020), the median number of major digestive surgeries performed monthly declined from 20 cases (range. 3‐100 cases) to 1 case (range. 0‐10 cases) (P < .001; Wilcoxon signed‐rank test). Most of the cases in April 2020 addressed emergency problems, but more definitive surgeries were performed during the later period of the survey. The importance of screening for COVID‐19 with polymerase chain reaction has increased over time, and a more comprehensive screening methodology incorporating real‐time polymerase chain reaction, chest CT, and rapid antibody test were evident in 31.37% of July 2020 responses.
Conclusion
Our survey has shown that surgeons adapted to the evolving pandemic and continue to do so only with appropriate safety assurances.
Background/objective
Tropical chronic pancreatitis (TCP) is common in developing countries and is defined as a juvenile form of chronic calcific non-alcoholic pancreatitis. Pseudocysts occur in 20–40% of chronic pancreatitis. TCP with pseudocyst has not been reported yet, so we represent this rare case to broaden the horizons regarding pancreatitis.
Case presentation
A 16-year-old woman suffered a painful lump in the upper abdomen. She came from a low-income family and frequently consumed cassava. There was intolerance of glucose in which admission blood sugar level of the patient increased by 179 mg/dl. An abdominal CT scan showed a mass around the pancreas, 20 cm in diameter, and located in retro-gastric. There were multiple ductal calculi along the major pancreatic duct with the largest stone was 3 cm in the pancreatic head. Longitudinal pancreaticojejunostomy (Partington-Rochelle procedure) has been performed and histopathological results appropriate with a pancreatic pseudocyst.
Clinical discussion
TCP with a giant pseudocyst is an interesting case report that has not been reported yet. This case met the clinical characteristics of TCP, such as young women, malnourished, history of cassava consumption, abdominal pain, and intolerance of glucose. A surgical intervention provides a satisfactory result to the patient.
Conclusion
Tropical chronic pancreatitis is a rare case. A pseudocyst adds the uniqueness of this case that has never been reported before. Appropriate management can provide satisfactory results and improve the quality of life for patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.