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https://www.readbyqxmd.com/read/29453728/single-site-port-robotic-assisted-hysterectomy-an-update
#1
REVIEW
Christos Iavazzo, Evelyn Eleni Minis, Ioannis D Gkegkes
Single-incision approach in robotic gynecology is a relatively new concept. The role of single-port systems in robotic hysterectomy, their advantages and disadvantages, as well as the technical challenges, are still under investigation. A systematic review was performed by searching in PubMed and Scopus databases. In 810 out of 1225 patients, hysterectomy was performed for non-neoplastic disease. Single-Site ® was the most common port system. Duration of the procedure and relative blood loss ranged from 60 to 311 min and 7 to 750 ml, respectively...
February 16, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29453164/perforated-giant-meckel-diverticulitis-in-an-elderly-patient-case-report-and-review-of-the-literature
#2
Ryan J Malcom, Izaskun M Iglesias, Eduardo Smith-Singares
INTRODUCTION: Giant Meckel's diverticula are a relatively rare form of Meckel's, and henceforth their natural history is not clearly defined. They're currently thought of as an infrequent form of ileal dysgenesis. Noted complications include perforation, torsion and bowel obstruction. A much rarer presentation is Giant Meckel's diverticulitis. CASE: A 71 year old white female presented herself to the Emergency Department of a small urban community hospital, complaining of severe abdominal pain, nausea & vomiting...
February 10, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29426650/the-ripasa-score-for-the-diagnosis-of-acute-appendicitis-a-comparison-with-the-modified-alvarado-score
#3
C Z Díaz-Barrientos, A Aquino-González, M Heredia-Montaño, F Navarro-Tovar, M A Pineda-Espinosa, I A Espinosa de Santillana
INTRODUCTION AND OBJECTIVES: Acute appendicitis is the first cause of surgical emergencies. It is still a difficult diagnosis to make, especially in young persons, the elderly, and in reproductive-age women, in whom a series of inflammatory conditions can have signs and symptoms similar to those of acute appendicitis. Different scoring systems have been created to increase diagnostic accuracy, and they are inexpensive, noninvasive, and easy to use and reproduce. The modified Alvarado score is probably the most widely used and accepted in emergency services worldwide...
February 6, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29414503/ileo-ileal-fistula-with-severe-malnutrition-caused-by-strangulated-ileus-surgery-while-preserving-ischemic-ileum-a-case-report
#4
Satoshi Nishiwada, Shinji Nakamura, Tetsuya Tanaka, Yuki Kirihataya, Daiki Nezu, Nobuhiro Sawa, Naoki Fujita, Haruka Ikegami, Atsushi Yoshimura
INTRODUCTION: Entero-enteric fistulas are rare complications that occur in patients with inflammatory bowel disease and other intestinal diseases. In this report, we present an ileo-ileal fistula accompanied by severe malnutrition caused by strangulated ileus surgery while preserving the ischemic ileum in a very elderly patient. CASE PRESENTATION: A 90-year-old woman underwent emergency surgery without bowel resection for strangulated ileus in another hospital. Minor abdominal pain and slight fever persisted after surgery...
January 27, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29410580/changes-in-thickness-of-the-transversus-abdominis-during-the-abdominal-drawing-in-manoeuvre-and-expiratory-muscle-training-in-elderly-people
#5
Takamune Sugimoto, Masami Yokogawa, Hiroichi Miaki, Sachiko Madokoro, Takao Nakagawa
[Purpose] It has been reported that exercises focusing upon the transversus abdominis (TrA) ameliorate low back pain (LBP). We investigated whether expiratory muscle training (EMT) can promote activity of the TrA to the same degree as the abdominal drawing-in manoeuvre (ADIM) in elderly individuals. [Subjects and Methods] Twenty-one elderly subjects (9 males, 12 females; mean age, 84.9 ± 6.6 years) without LBP symptoms were included. Using ultrasound imaging we measured changes in thickness of the lateral abdominal muscles, TrA, internal oblique muscle (IO), and external oblique muscle (EO) during ADIM and EMT...
January 2018: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/29404916/a-case-of-pancreatic-av-malformation-in-an-elderly-man
#6
Vipin Gupta, Saurabh Kedia, Ujjwal Sonika, Kumble Seetharama Madhusudhan, Sujoy Pal, Pramod Garg
A 60-year-old man presented with recurrent abdominal pain and weight loss for 6 months. Abdominal imaging showed a large vascular lesion in the head and neck of pancreas suggestive of arteriovenous malformation (AV malformation). Endoscopic ultrasound was done which showed features of AV malformation with no evidence of pancreatic malignancy. Surgery was planned for definitive treatment of malformation. Digital subtraction angiography with angioembolization was done prior to surgery to reduce vascularity of the lesion...
February 5, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29398874/intraductal-papillary-bile-duct-adenocarcinoma-and-gastrointestinal-stromal-tumor-in-a-case-of-neurofibromatosis-type-1
#7
Jung Min Lee, Jae Min Lee, Jong Jin Hyun, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hoon Jai Chun, Hong Sik Lee, Chang Duck Kim, Dong Sik Kim, Joo Young Kim
We report our experience with a synchronous case of gastrointestinal stromal tumor (GIST) and intraductal papillary neoplasm of the bile duct (IPNB) in an elderly woman with neurofibromatosis type 1 (NF-1). A 72-year-old woman presented with a 2-mo history of right upper abdominal pain unrelated to diet and indigestion. Fourteen years earlier, she had been diagnosed with NF-1, which manifested as café au lait spots and multiple nodules on the skin. Computed tomography (CT) revealed a multilocular low-density mass with septation, and mural nodules in the right hepatic lobe, as well as a 1...
January 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29394640/-a-two-stage-right-hemicolectomy-case-in-which-the-first-surgery-was-laparoscopic-ileocecal-resection-based-on-preoperative-diagnosis-of-acute-appendicitis
#8
Satoshi Kataoka, Kei Naito, Koji Miyagawa, Yosuke Ishihara, Nobuaki Fuji
We report a case oftwo -stage right hemicolectomy in which the first surgery performed was laparoscopic ileocecal resection based on the preoperative diagnosis ofacute appendicitis. The second surgery was performed based on pathological diagnosis ofadvanced cecal cancer accompanied by appendicitis. A 49-year-old woman came to our hospital with a chief complaint of abdominal pain in the lower quadrant for 1 week. Blood test results indicated an inflammatory response, with white blood cells at 10,000/mL and C-reactive protein of1 7...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29393040/perioperative-treatment-of-patients-undergoing-acute-high-risk-abdominal-surgery%C3%A2
#9
Line Toft Tengberg
Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, prolonged hospitalisation and considerable risk of permanent disability. With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group...
February 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29390582/a-klebsiella-pneumoniae-liver-abscess-presenting-with-myasthenia-and-tea-colored-urine-a-case-report-and-review-of-77-cases-of-bacterial-rhabdomyolysis
#10
Lihua Deng, Rong Jia, Wei Li, Qian Xue, Jie Liu, Yide Miao, Jingtong Wang
RATIONALE: Rhabdomyolysis is a well-known syndrome in clinical practice, although rhabdomyolysis caused by a liver abscess is rarely reported and the patient may lack symptoms that are associated with a primary site of infection. Early recognition of this possibility is needed to avoid diagnostic delay and facilitate treatment. We report the case of a 71-year-old woman with a Klebsiella pneumoniae (KP) pyogenic liver abscess who presented with myasthenia and tea-colored urine and also review the 77 reported cases of bacterial rhabdomyolysis...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29390514/successful-gamma-knife-radiosurgery-combined-with-s-1-in-an-elderly-man-with-local-recurrent-pancreatic-cancer-a-case-report
#11
Juan Wei, XiaoFang Dong, FangMing Du, Sheng Tang, HangPing Wei
RATIONALE: Pancreatic cancer is common in people older than 40 years, and the incidence peaks at the age of 70 years and older. Chemoradiotherapy has been generally considered a high-risk procedure in elderly patients with local recurrent pancreatic cancer. Gamma knife stereotactic radiosurgery has the advantage in protecting the surrounding tissues, and providing short-term effects. It has been successfully used in patients with brain metastases.The efficacy of GKSRS in other malignancies has barely been studied...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29372125/dilated-thoracic-esophagus-presenting-with-painful-progressive-persistent-dysphagia-and-leukocytosis-of-unknown-origin
#12
Kyawzaw Lin, Jamil Shah, Emmanuel Ofori, Vahe Shahnazarian, Madhavi Reddy
Esophageal cancer is the eighth-most common cause of cancer-related mortality worldwide. The most common presenting symptom in advanced distal esophageal cancer is the sensation of sticking food, but it may sometimes present with bleeding and related complications, or asymptomatic leukocytosis. We present the case of a 77-year-old afebrile man with chronic alcoholism and a dilated thoracic esophagus with painful, progressive, and persistent dysphagia and leukocytosis of unknown origin. A 77-year-old man with a past medical history of hypertension and colonic cancer status post right hemicolectomy (surveillance negative) presented to the emergency department with painful, progressive, persistent, and worsening dysphagia for the past three weeks...
November 16, 2017: Curēus
https://www.readbyqxmd.com/read/29337450/-emergency-medicine-update-2017
#13
Frédéric Rouyer, Fabrice Dami, Olivier Grosgurin, Valériane Rossier, Majd Ramlawi, Mathieu Pasquier, Olivier T Rutschmann
Emergency medicine is part of the current stream of efficient and qualitative medicine : 1) the modified Valsava maneuver results in the resolution of almost 50% of supra-ventricular tachycardia without any drug; 2) lung echography performed by emergency physicians is a very sensitive and specific diagnostic tool for most thoracic emergencies; 3) cardiopulmonary resuscitation initiated by lay-rescuers improves short and long-term outcome; 4) no anticoagulant treatment is warranted in distal deep vein thrombosis and 5) systematic unenhanced abdominal CT might improve evaluation of elderly patients with acute abdominal pain...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29333014/is-colorectal-cancer-in-young-40-years-different-from-those-in-the-elderly-40-years-experience-from-a-regional-care-center
#14
Rudresha A Haleshappa, Suparna Ajit Rao, Sunny Garg, C Lakshmaiah Kuntegowdanahalli, Govinda Babu Kanakasetty, Lokanatha Dasappa
Background: Colorectal cancer (CRC) is considered a disease of elderly. There has been a steady decrease in the incidence in those aged >50 years, with an alarming increase noted in adults aged <50 years. Subjects and Methods: We retrospectively analyzed 89 patients diagnosed with CRC aged <40 years between the years 2010 and 2014. Their clinical profile, treatment, and outcomes were studied. Results: The median age was 33 years with a male preponderance (56...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29303097/-abdominal-wall-paresis-as-a-complication-of-herpes-zoster
#15
B Geboers, C J Verveld, I Bronner, A H W van de Ven
BACKGROUND: Herpes zoster is an illness which is especially common amongst the elderly in the Netherlands and which can express itself in various ways. Besides affecting sensory nerves, which leads to postherpetic pain, the varicella zoster virus may also invade motor nerves. CASE DESCRIPTION: A 73-year-old female went to the surgeon with symptoms of a painful swelling in the left lower abdomen. She had experienced herpes zoster at the site of the swelling a few months earlier...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29274599/bowel-obstruction-in-obturator-hernia-a-challenging-diagnosis
#16
L Conti, E Baldini, P Capelli, C Capelli
INTRODUCTION: The obturator hernia is a rare pelvic hernia that often comes in the shape of bowel obstruction caused by the presence of an intestinal segment, more often ileum, passing trough the obturator foramen of the pelvic wall (Fig. 1). This type of hernia accounts for 0.5-1.4% of all hernias. CASE PRESENTATION: We report the clinical case of a 84-year-old woman with no previous surgical interventions, who went to the emergency room complaining of vomit and nausea, bowels closed to gas and stool, which she had experienced for three previous days...
December 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29250315/hepatic-portal-venous-gas-acute-deterioration-in-an-elderly-patient
#17
Brett Sydney Bernstein, Rory George Callan, Darryl Ethan Bernstein, Tom Pampiglione
A 91-year-old female presented to the Emergency Department with a 10-day history of constipation and abdominal pain. Abdominal examination was normal and rectal examination showed faecal loading. A phosphate enema was given and the patient was admitted. Overnight, the patient's GCS dropped from 15/15 to 3/15 and an arterial blood gas showed a lactate of 8 mmol/L (1.5 on admission). Abdomen remained soft throughout. A CT scan showed a large amount of free air and free fluid within the abdomen and pelvis, highly suspicious for perforation...
December 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29241725/value-of-water-enema-computed-tomography-in-elderly-symptomatic-patients
#18
Heyfa Romdhane, Imen Marzouk, Zeineb Mzoughi, Meriem Cheikh, Meriem Dridi, Houcem Fadhl, Rym Ennaifer, Najet Belhadj
BACKGROUND AND STUDY AIMS: Colonoscopy remains the gold standard for the examination of the colon. However, its use in the elderly is not well tolerated, and there is often a need for general anaesthesia, thus increasing the risk, especially if there are co-morbidities. Water enema computed tomography has been suggested to be a satisfactory alternative as a non-invasive, fast and effective means for the diagnosis of colorectal supra-centimetric lesions. The aim of our study was to assess the performance of water enema computed tomography as first-line examination by calculating its negative predictive value (NPV) for the diagnosis of supra-centimetric lesions in symptomatic elderly referred to colonoscopy...
December 11, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/29231349/-effect-of-ear-point-embedding-on-plasma-and-effect-site-concentrations-of-propofol-remifentanil-in-elderly-patients-after-target-controlled-induction
#19
Xiaochun Zheng, Liling Wan, Fei Gao, Jianghu Chen, Wenshao Tu
OBJECTIVE: To observe the clinical effect of ear point embedding on plasma and effect site concentrations of propofol-remifentanil in elderly patients who underwent abdominal external hernia surgery at the time of consciousness and pain disappearing by target-controlled infusion (TCI) and bispectral index (BIS). METHODS: Fifty patients who underwent elective abdominal hernia surgery were randomly assigned into an observation group and a control group, 25 cases in each one...
August 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29201469/perforated-duodenal-diverticulum-with-subtle-pneumoretroperitoneum-on-abdominal-x-ray
#20
Yuzeng Shen, Mark Kwok Fai Leong
Abdominal pain is one of the most common presenting complaints at the Emergency Department (ED). Given the myriad of possible differential diagnoses for abdominal pain, it becomes more important to diagnose conditions requiring emergent surgical intervention early. We present a case of an elderly male patient with abdominal pain secondary to perforated hollow viscus, subtle evidence of pneumoretroperitoneum on the initial supine abdominal X-ray, and review the signs of pneumoperitoneum and pneumoretroperitoneum on plain abdominal X-rays...
2017: Case Reports in Emergency Medicine
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