FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2340389901> ?p ?o ?g. }

• W2340389901 endingPage "914" @default.
• W2340389901 startingPage "912" @default.
• W2340389901 abstract "To the Editor: A devastating complication of severe, chronic constipation is a stercoral perforation (SP), in which hard, impacted stool causes pressure necrosis of the distal colon, leading to ulceration and subsequent perforation of the intestinal wall. Although uncommon, this surgical emergency disproportionally affects older adults.1 and is associated with significant perioperative mortality.2 SP is often diagnosed intraoperatively rather than preoperatively; its apparent rarity may be the result of underrecognition.3 Risk factors and diagnostic criteria for SP have been described,4 but the burden of disease is poorly defined. A retrospective review of surgical records at a tertiary care community teaching hospital was performed to better understand this condition. The goal was to identify further risk factors and to characterize the incidence of SP. After institutional review board approval was received, all individuals undergoing emergency colon resection between January 1, 2003, and December 31, 2012, at a single institution were reviewed. Individuals with SP noted in postoperative documentation were included in the study. Individuals with no clinical SP diagnosis but with suspicious or indeterminate intraoperative findings underwent close review of intraoperative descriptive findings and pathology reports. Individuals were also included in the study if they retrospectively met Maurer's stringent criteria for perforated stercoral ulcers (round or ovoid perforation >1 cm, fecalomas (Figure 1) in colon or abdomen, pressure necrosis, or chronic inflammation).3 Those with other colonic pathology, including diverticulitis, inflammatory bowel disease, and mesenteric ischemic disease, were excluded. The charts of individuals with SP were reviewed for comorbidities, risk factors, and surgical outcomes. Between January 1, 2003, and December 31, 2012, 1,098 individuals underwent colon resection at this tertiary care community teaching hospital; after the exclusion of elective cases, 326 individuals who had undergone emergency colon resection were identified. Twelve individuals with SP were identified according to documented postoperative diagnoses. The operative and pathology reports of the remaining individuals undergoing emergency colon resection with suspicious clinical findings were evaluated. Six individuals were subsequently identified and included in the study based on published SP criteria.3 The 18 individuals with SP accounted for 5.5% of all emergency colon resections over 10 years. Women accounted for 77.8% of the study group (14/18). Mean age was 72.3. Fifteen (83.3%) had a documented recent history of constipation. Twelve (66.7%) had documentation of recent narcotic use. Five (28%) had recently undergone surgery, including several orthopedic procedures. Perforations were uniformly located in the sigmoid colon or rectum and had a mean size of 2.1 cm (1.0–4.5 cm). Seventeen individuals had free perforation into the abdomen (Figure 1). One had perforation of the rectovaginal septum, leading to a colovaginal fistula. All individuals underwent resection with ostomy formation. In-hospital mortality was 28%. SP is an uncommon, life-threatening condition often affecting older adults, who frequently have chronic constipation or fecal impaction.5 Fewer than 150 cases of SP were found in the literature, but larger case series have recently been published.1, 6, 7 and may indicate rising incidence or improved recognition. The current study identified 18 individuals with SP, who accounted for 5.5% of emergency colon resections over 10 years at a tertiary care community teaching hospital. One-third of the cases met pathological criteria without evidence of clinical recognition, which supports the assertion that the condition is more common than described. Mortality (28%) was consistent with previously published results, which range from 25% to as high as 57%.2 Previously identified SP risk factors, which were also noted in this population, include chronic constipation, female sex, older age, nursing facility residence, use of constipating medications (opiates, anticholinergics, tricyclics), and evidence of fecal impaction.1, 4, 6 Several individuals had undergone recent surgical procedures, which may be a unifying etiology by exacerbating constipation and contributing to nursing home stays and opiate use. Individuals often present urgently and require immediate operative intervention. Given the high mortality of the condition, prevention and early recognition are essential, but only 10% of individuals are diagnosed preoperatively.8 Constipation affects up to 74% of elderly nursing home residents and may be seen in individuals who also have chronic abdominal pain and an altered sensorium.9, 10 This can cloud evaluation and make early diagnosis of this acute condition difficult. As useful adjuncts to a thorough history and physical, early radiography or computed tomography may combat the unreliable nature of subjective complaints and facilitate early, accurate diagnosis and treatment. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Author Contributions: Gough, Donovan, Greaney: concept and design; acquisition, analysis, and interpretation of data. Grotts: analysis and interpretation of data. Gough, Greaney: Preparation of manuscript. Sponsor's Role: None." @default.
• W2340389901 created "2016-06-24" @default.
• W2340389901 creator A5021498825 @default.
• W2340389901 creator A5028090846 @default.
• W2340389901 creator A5064761289 @default.
• W2340389901 creator A5074102777 @default.
• W2340389901 date "2016-04-01" @default.
• W2340389901 modified "2023-09-27" @default.
• W2340389901 title "Perforated Stercoral Ulcer: A 10-Year Experience" @default.
• W2340389901 cites W1544954959 @default.
• W2340389901 cites W2006658244 @default.
• W2340389901 cites W2039625874 @default.
• W2340389901 cites W2048628362 @default.
• W2340389901 cites W2054655660 @default.
• W2340389901 cites W2064425248 @default.
• W2340389901 cites W2065604705 @default.
• W2340389901 cites W2108784335 @default.
• W2340389901 cites W2134404506 @default.
• W2340389901 cites W2169478027 @default.
• W2340389901 doi "https://doi.org/10.1111/jgs.14057" @default.
• W2340389901 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/27100603" @default.
• W2340389901 hasPublicationYear "2016" @default.
• W2340389901 type Work @default.
• W2340389901 sameAs 2340389901 @default.
• W2340389901 citedByCount "8" @default.
• W2340389901 countsByYear W23403899012017 @default.
• W2340389901 countsByYear W23403899012019 @default.
• W2340389901 countsByYear W23403899012020 @default.
• W2340389901 countsByYear W23403899012021 @default.
• W2340389901 countsByYear W23403899012022 @default.
• W2340389901 countsByYear W23403899012023 @default.
• W2340389901 crossrefType "journal-article" @default.
• W2340389901 hasAuthorship W2340389901A5021498825 @default.
• W2340389901 hasAuthorship W2340389901A5028090846 @default.
• W2340389901 hasAuthorship W2340389901A5064761289 @default.
• W2340389901 hasAuthorship W2340389901A5074102777 @default.
• W2340389901 hasBestOaLocation W23403899011 @default.
• W2340389901 hasConcept C120665830 @default.
• W2340389901 hasConcept C121332964 @default.
• W2340389901 hasConcept C126322002 @default.
• W2340389901 hasConcept C141071460 @default.
• W2340389901 hasConcept C167135981 @default.
• W2340389901 hasConcept C191897082 @default.
• W2340389901 hasConcept C192562407 @default.
• W2340389901 hasConcept C2777929615 @default.
• W2340389901 hasConcept C2778456384 @default.
• W2340389901 hasConcept C2778527123 @default.
• W2340389901 hasConcept C2779134260 @default.
• W2340389901 hasConcept C2781112942 @default.
• W2340389901 hasConcept C31174226 @default.
• W2340389901 hasConcept C61434518 @default.
• W2340389901 hasConcept C61511704 @default.
• W2340389901 hasConcept C71924100 @default.
• W2340389901 hasConcept C81182388 @default.
• W2340389901 hasConceptScore W2340389901C120665830 @default.
• W2340389901 hasConceptScore W2340389901C121332964 @default.
• W2340389901 hasConceptScore W2340389901C126322002 @default.
• W2340389901 hasConceptScore W2340389901C141071460 @default.
• W2340389901 hasConceptScore W2340389901C167135981 @default.
• W2340389901 hasConceptScore W2340389901C191897082 @default.
• W2340389901 hasConceptScore W2340389901C192562407 @default.
• W2340389901 hasConceptScore W2340389901C2777929615 @default.
• W2340389901 hasConceptScore W2340389901C2778456384 @default.
• W2340389901 hasConceptScore W2340389901C2778527123 @default.
• W2340389901 hasConceptScore W2340389901C2779134260 @default.
• W2340389901 hasConceptScore W2340389901C2781112942 @default.
• W2340389901 hasConceptScore W2340389901C31174226 @default.
• W2340389901 hasConceptScore W2340389901C61434518 @default.
• W2340389901 hasConceptScore W2340389901C61511704 @default.
• W2340389901 hasConceptScore W2340389901C71924100 @default.
• W2340389901 hasConceptScore W2340389901C81182388 @default.
• W2340389901 hasIssue "4" @default.
• W2340389901 hasLocation W23403899011 @default.
• W2340389901 hasLocation W23403899012 @default.
• W2340389901 hasOpenAccess W2340389901 @default.
• W2340389901 hasPrimaryLocation W23403899011 @default.
• W2340389901 hasRelatedWork W1993424441 @default.
• W2340389901 hasRelatedWork W2076885820 @default.
• W2340389901 hasRelatedWork W2170272972 @default.
• W2340389901 hasRelatedWork W2322864005 @default.
• W2340389901 hasRelatedWork W2376769477 @default.
• W2340389901 hasRelatedWork W2385103485 @default.
• W2340389901 hasRelatedWork W2392134161 @default.
• W2340389901 hasRelatedWork W2404681692 @default.
• W2340389901 hasRelatedWork W3208701539 @default.
• W2340389901 hasRelatedWork W3006168697 @default.
• W2340389901 hasVolume "64" @default.
• W2340389901 isParatext "false" @default.
• W2340389901 isRetracted "false" @default.
• W2340389901 magId "2340389901" @default.
• W2340389901 workType "article" @default.