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Tartaglia D, Coccolini F, Mazzoni A, Strambi S, Cicuttin E, Cremonini C, Taddei G, Puglisi AG, Ugolini C, Di Stefano I, Basolo F, Chiarugi M. Sarcina Ventriculi infection: a rare but fearsome event. A Systematic Review of the Literature. Int J Infect Dis 2021; 115:48-61. [PMID: 34838720 DOI: 10.1016/j.ijid.2021.11.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES This study is aimed to report a case of SV-related gastritis and the results of a systematic literature review of SV infections. METHODS Following a case presentation, we systematically searched different databases (MEDLINE, PubMed, Scopus, Web of Science, EMBASE, google scholar) for the items "sarcina," "ventriculi," "clostridium" with AND/OR. RESULTS A total of 55 articles reporting 65 cases of Sarcina Ventriculi were found. Thus, 66 patients, including our case, were reviewed. The median age was 51 years (IQR: 0-87 years). Females accounted for 51% of cases. 68% of patients had one or more comorbidities. SV was isolated in the gastrointestinal tract (88%), respiratory (5%), urine (4%), and bloodstream (3%) systems. Upper endoscopy was performed in 52 patients (79%). Biopsies were obtained in all 52 cases and were normal in 23%. Surgery was warranted in 15 patients (23%), and specific antimicrobial therapy was delivered in 34 (52%) patients. Mortality was 14%. At follow-up, 88% of patients showed complete eradication of the SV infection. CONCLUSIONS Upper gastrointestinal biopsy positive for SV should prompt an evaluation of the clinical conditions, considering the risk of gastric perforation is not negligible. Antibiotic therapy may eradicate the infection and prevent complications. Emergency surgery is required in case of source control.
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Affiliation(s)
- Dario Tartaglia
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy.
| | - Federico Coccolini
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Alessio Mazzoni
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Silvia Strambi
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Enrico Cicuttin
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Camilla Cremonini
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Giacomo Taddei
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Adolfo Gabriele Puglisi
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Clara Ugolini
- Anatomic Pathology Section, Department of Surgical, Medical, Molecular Pathology, and Critical Area, Pisa University Hospital, Pisa, Italy
| | - Iosè Di Stefano
- Anatomic Pathology Section, Department of Surgical, Medical, Molecular Pathology, and Critical Area, Pisa University Hospital, Pisa, Italy
| | - Fulvio Basolo
- Anatomic Pathology Section, Department of Surgical, Medical, Molecular Pathology, and Critical Area, Pisa University Hospital, Pisa, Italy
| | - Massimo Chiarugi
- Emergency Surgery Unit and Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy
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Tartaglia D, Mazzoni A, Puglisi AG, Coccolini F, Chiarugi M. Intra-operative enteroscopy for the identification of obscure bleeding source caused by gastrointestinal angiodysplasias: through a balloon-tip trocar is better. Colorectal Dis 2020; 22:2326-2329. [PMID: 32881237 DOI: 10.1111/codi.15348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/31/2020] [Accepted: 08/22/2020] [Indexed: 02/08/2023]
Abstract
AIM Intra-operative enteroscopy (IE) is a valid diagnostic tool which can be adopted in order to identify the precise location of bleeding gastrointestinal angiodysplasias (GIADs) of the small bowel. We describe a novel IE technique that may increase the diagnostic yield by maintaining a steady distension of the bowel and that prevents microtrauma to the intestinal mucosa and spillage of enteric content into the operative field. METHODS After laparotomy, a centimetric transverse enterotomy is performed approximately at the middle of the small bowel. A 12-mm trocar with balloon is then introduced and insufflated. The small bowel is gently distended by carbon dioxide insufflation. Through the trocar, a paediatric colonscope is then inserted and the enteroscopy is performed either retrogradely to the duodenum or anterogradely to the caecum. Once located, surgery is tailored to the precise site of bleeding, with a consequent sparing of intestinal resection. RESULTS IE with 12-mm trocar with balloon was adopted in four elderly patients undergoing surgery for bleeding GIADs. The length of small bowel resection ranged from 10 to 200 cm, depending on the number of GIADs. Operating time ranged from 210 to 275 min. Intra-operative blood loss was nil. No patient developed organ-space or wound infections. There was no recurrence of bleeding from the midgut. CONCLUSION Performing IE through a balloon trocar may increase the diagnostic accuracy of the procedure with the benefit of reducing the risk of traumatic injury to the bowel and the risk of surgical site infection.
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Affiliation(s)
- D Tartaglia
- Emergency Surgery Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - A Mazzoni
- Emergency Surgery Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - A G Puglisi
- Emergency Surgery Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - F Coccolini
- Emergency Surgery Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - M Chiarugi
- Emergency Surgery Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
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