Srinivas Kavuturu
Michigan State University
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Publication
Featured researches published by Srinivas Kavuturu.
Scandinavian Journal of Surgery | 2009
David C. Evans; Vijay Doraiswamy; Prosciak Mp; Matthew L. Silviera; Mark J. Seamon; V. Rodriguez Funes; J. Cipolla; Wang Cf; Srinivas Kavuturu; D. A. Torigian; Charles H. Cook; David E. Lindsey; Steven M. Steinberg; Stanislaw P Stawicki
Care for the critically ill patient requires maintenance of adequate tissue perfusion/oxygenation. Continuous hemodynamic monitoring is frequently utilized to achieve these objectives. Pulmonary artery catheters (PAC) allow measurement of hemodynamic variables that cannot be measured reliably or continuously by less invasive means. Inherent to every medical intervention are risks associated with that intervention. This review categorizes complications associated with the PAC into four broad groups — Complications of central venous access; complications related to PAC insertion and manipulation; complications associated with short- or long-term presence of the PAC in the cardiovascular system; and errors resulting from incorrect interpretation/use of PAC-derived data. We will discuss each of these four broad categories, followed by in-depth descriptions of the most common and most serious individual complications.
Scandinavian Journal of Surgery | 2012
S. Prabhakaran; Vijay Doraiswamy; V. Nagaraja; James Cipolla; U. Ofurum; David C. Evans; David E. Lindsey; Mark J. Seamon; Srinivas Kavuturu; Anthony T. Gerlach; N. P. Jaik; Daniel S. Eiferman; Thomas J. Papadimos; M. D. Adolph; Charles H. Cook; Stanislaw P Stawicki
The use of nasoenteric tubes (NETs) is ubiquitous, and clinicians often take their placement, function, and maintenance for granted. NETs are used for gastrointestinal decompression, enteral feeding, medication administration, naso-biliary drainage, and specialized indications such as upper gastrointestinal bleeding. Morbidity associated with NETETs is common, but frequently subtle, mandating high index of suspicion, clinical vigilance, and patient safety protocols. Common complications include sinusitis, sore throat and epistaxis. More serious complications include luminal perforation, pulmonary injury, aspiration, and intracranial placement. Frequent monitoring and continual re-review of the indications for continued use of any NETET is prudent, including consideration of changing goals of care. This manuscript reviews NET-related complications and associated topics.
Obesity Surgery | 2012
Srinivas Kavuturu; Ann M. Rogers; Randy S. Haluck
Routine drain use after laparoscopic Roux-en-y gastric bypass (LRYGB) is still practiced by many bariatric surgeons. After a patient in our program experienced intestinal obstruction secondary to a drain, we reevaluated our practice and hypothesized drains would be of no benefit and potentially harmful after LRYGB. Retrospective record review of all patients undergoing LRYGB from August 2005 to August 2009 was performed. As we changed our practice in December 2006, we have two comparable groups: one with a drain placed at surgery and one without. All operations were otherwise performed in an identical fashion by three fellowship-trained university surgeons. We compared outcomes between the two groups, particularly regarding gastrojejunal (GJ) leaks. Jejunojejunal (JJ) leaks, unlikely to be captured by these drains, were not studied. A total of 755 LRYGBs were performed during the study period, the first 272 patients with routine drains and the subsequent 483 without. Demographics were statistically similar between the two groups. There were four GJ leaks in the drain group (1.47%) and three in the nondrain group (0.62%). Among the drain patients, two required operation and two were treated nonoperatively. Among the nondrain patients, two required operation and one was treated nonoperatively. The leak and reoperation rates between the groups were not statistically different (p = 0.154 and p = 0.514). Routine drains likely have no benefit after LRYGB. Clinical parameters such as tachycardia, fever, oliguria, and increasing abdominal pain should guide further investigation for and treatment of a leak.
Journal of the Pancreas | 2013
Srinivas Kavuturu; Nabeel Sarwani; Fransesca M Ruggeiro; Isabelle Deshaies; Eric T. Kimchi; Jussuf T. Kaifi; Kevin F. Staveley-O'Carroll; Niraj J. Gusani
CONTEXT Lymphoepithelial cysts of the pancreas are rare true benign cystic tumors of the pancreas of uncertain etiology. Cystic neoplasms of the pancreas present a significant diagnostic dilemma in differentiating benign from premalignant or malignant variants. Since the first description of lymphoepithelial cysts in 1985, 109 cases have been reported in the literature. We describe 6 cases of this rare tumor, the preoperative imaging results, and a review the literature. PATIENTS Five males and one female ranging in age from 47 to 76 years underwent resection for lymphoepithelial cysts. Five patients presented with abdominal pain related to the lesion and in one patient the lesion was discovered incidentally. Four patients had elevated serum CA 19-9 levels. Pre-operative imaging with a CT scan and MRI of the abdomen typically revealed a well defined hypodense mass with Hounsfield units (HU) in the range of 15 to 20. One patient had papillary projections into the lesion. The mean size was 3.3 cm (ranging from 1.8 cm to 4 cm). All lesions were exophytic off the pancreatic parenchyma (1 cyst was located in the head of the pancreas, 2 were in the body, and 3 were in the tail region). Pre-operative EUS-guided/CT-guided needle aspiration, when performed, was not diagnostic. All patients underwent resection (one pancreaticoduodenectomy, five left pancreatectomies) to remove these cystic neoplasms. Pathology revealed a cyst lined by non-dysplastic squamous cells surrounded by sheets of benign lymphocytes. No evidence of malignancy was found. CONCLUSION Lymphoepithelial cysts of the pancreas are rare and are characteristically seen in men. While a hypodense mass (less than 20 HU) with papillary projections should be considered suspicious for lymphoepithelial cyst, a definitive diagnosis cannot be made solely based on preoperative imaging. EUS-guided biopsy coupled with biochemical/tumor marker studies are increasingly being used as a diagnostic tool to help differentiate between the various types of cystic pancreatic neoplasms. Imaging findings of lymphoepithelial cysts are non-specific and hence surgical resection is often required to rule out the presence of a malignant or pre-malignant cystic pancreatic lesion. In true lymphoepithelial cysts, malignant transformation is not seen and patients who have these cysts are not at increased risk of developing a pancreatic malignancy.
World Journal of Surgical Oncology | 2012
Dinesh Vyas; Kerent Pihl; Srinivas Kavuturu; Arpita Vyas
The benign cystic mesothelioma of the peritoneum is a rare lesion and is known for local recurrence. This is first case report of a rapidly developing massive abdominal tumor with histological finding of benign cystic mesothelioma (BCM). We describe a BCM arising in the retroperitoneal tis[sue on the right side, lifting ascending colon and cecum to the left side of abdomen. Patient was an active 58-year-old man who noticed a rapid abdominal swelling within a two month time period with a weight gain of 40 pounds. Patient had no risk factors including occupational (asbestos, cadmium), family history, social (alcohol, smoking) or history of trauma. We will discuss the clinical, radiologic, intra-operative, immunohistochemical, pathologic findings, and imaging six months after surgery. Patient has no recurrence and no weight gain on follow up visits and imaging.
International Journal of Academic Medicine | 2017
Srinivas Kavuturu; Vellore S. Parithivel; John Morgan Cosgrove
Biliary-enteric fistula is a rare complication of gallstone disease, and gallstone ileus is relatively a rare cause of intestinal obstruction. Most commonly, the stone lodges in the distal ileum, colon, or duodenum. The least common site of obstruction is the proximal duodenum or pylorus causing gastric outlet obstruction (Bouverets syndrome). Presenting signs and symptoms of Bouverets syndrome include nausea, vomiting, epigastric pain, and abdominal distension. Obstructive jaundice, gastrointestinal hemorrhage with or without hematemesis, pancreatitis, and duodenal perforation are less common. Abdominal radiography may show air in the biliary tree, mechanical bowel obstruction, and radio-opaque gallstone suggesting the diagnosis. Abdominal ultrasound or computerized tomography is diagnostic in about 60% of cases. In most cases, the treatment of Bouverets syndrome is surgical. Surgical options include (a) a single-staged enterolithotomy (or gastrostomy) with concomitant cholecystectomy and repair of the fistula or (b) an enterolithotomy alone with or without a second-stage cholecystectomy. Endoscopic extraction of the stone has been described in selected patients. Lithotripsy techniques have also been successfully used to fragment large stones. The authors present a case of Bouverets syndrome as well as a brief literature review of this topic. The following core competencies are addressed in this article: Medical knowledge and patient care. Republished with permission from: Kavuturu S, Parithivel V, Cosgrove J. Bouverets syndrome: A rare presentation of gallstone disease. OPUS 12 Scientist 2008;2(2):11-12.
Journal of Gastrointestinal Cancer | 2014
Peter C. Kurniali; Srinivas Kavuturu; Neil Caliman; Anas Al-Janadi
Gallbladder cancer is a relatively uncommonmalignancy with approximately 5,000 new cases diagnosed each year in the USA [1, 2]. The majority of gallbladder cancers are adenocarcinoma (about 90 %) with squamous cell carcinoma accounting for only about 1–2 % of all cases [3–6]. The overall prognosis of squamous cell carcinoma is significantly worse than adenocarcinoma [5]. Gall bladder cancer is often diagnosed at an advanced stage due to the aggressive biological nature of the tumor and non-specific initial clinical presentation, such as bloating and/or right upper quadrant discomfort. In other instances, gallbladder cancer is found incidentally at surgery or on pathologic review following cholecystectomy [7]. The most common sites of distant metastases are the peritoneum, liver, and lung [8]. However, it is known to metastasize to unusual sites such as skin and subcutaneous tissue, breast, heart, and muscle [9, 10]. Metastasis of adenocarcinoma of the gallbladder to the thyroid has also been reported in the past [11]. Case Report
The Journal of Thoracic and Cardiovascular Surgery | 2012
Jussuf T. Kaifi; Srinivas Kavuturu; Dejah R. Judelson; Kevin F. Staveley-O’Carroll
Diaphragmatic hernias occur in as many as 6% of patients after thoracoabdominal trauma, with the majority occurring on the left side as a result of the cushioning effects of the liver. Diagnosis is delayed in as many as 60% of all cases, and symptoms are nonspecific and include abdominal pain, shortness of breath, chest pain, cough, and tachypnea. We report a patient with chronic hepatothorax resulting from a right-sided diaphragmatic rupture after a remote history of blunt trauma more than 20 years previously presenting with irreversible Budd-Chiari syndrome in the right liver.
Surgery | 2018
John J. Kanitra; John C. Hardaway; Tahereh Soleimani; Tracy J. Koehler; Michael K. McLeod; Srinivas Kavuturu
Background: Adrenocortical oncocytic neoplasms are rare tumors, generally regarded as benign and hormonally nonfunctional. We performed a systematic review to update the literature on adrenocortical oncocytic neoplasms by reviewing patient and tumor characteristics, as well as management trends, because the literature is composed of predominately single‐case reports. Methods: A systematic search was performed in PubMed, Embase, and Cochrane Library through June 2017. Malignant potential was determined by applying the Lin‐Weiss‐Bisceglia criteria to cases. Results: Included for analysis were 84 citations describing 140 adrenocortical oncocytic neoplasms, including our own case. These were diagnosed predominantly in females (66%), on the left side (64%), and were nonfunctional (66%). Average age at diagnosis was 44 years (2.5–77), and median tumor size was 80 mm (16–285). A total of 35% of adrenocortical oncocytic neoplasms were benign, 41% borderline, and 24% malignant. Male patients were more likely to have a malignant tumor compared with females (36% versus 18%, P = .035). The 5‐year overall survival for benign adrenocortical oncocytic neoplasms was 100%, borderline 88%, and malignant 47%. Hormonal function did not discriminate malignant from benign lesions. Adrenocortical oncocytic neoplasms that stained positive for synaptophysin (50%, P < .001) and negative for vimentin (62%, P = .009) are more often benign. Conclusion: We found that the majority of adrenocortical oncocytic neoplasms (65%) were either malignant or had malignant potential, contrary to the previous literature. The Lin‐Weiss‐Bisceglia criteria are useful in identifying those patients for whom closer surveillance is warranted, because their prognosis is dependent on the Lin‐Weiss‐Bisceglia diagnosis.
American Surgeon | 2006
Srinivas Kavuturu; H. T. Girishkumar; Frank Ehrlich