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https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#1
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28936998/venous-thromboembolism-due-to-hyperhomocysteinaemia-and-tuberculosis
#2
Ankush Chaudhary, Unnati Desai, Jyotsna M Joshi
An 18-year-old male presented to our hospital with complaints of episodic abdominal pain, dry cough and right pleuritic chest pain. He was diagnosed as a case of right tuberculous pleural effusion on the basis of the pleural fluid Genexpert report of Mycobacterium tuberculosis detected sensitive to rifampicin and was started on antituberculous therapy. Forty-five days later, he presented with acute onset breathlessness, swelling of the right leg, streaky haemoptysis and a fresh left-sided pleural effusion. Evaluation revealed venous thromboembolism (right lower lobar segment pulmonary embolism with right leg deep vein thrombosis)...
May 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28936875/hemosuccus-pancreaticus-secondary-to-pseudoaneurysm-of-the-splenic-artery
#3
Mariano José Parada Blázquez, Andrea Núñez Ortiz
A 41-years-old male who presents abdominal pain and rectal bleeding with acute anemization. Both the gastroscopy and the colonoscopy dont identify any potential cause of bleeding. The computed tomography (CT) shows a pseudoaneurysm of the splenic artery. Gastrointestinal bleeding was attributed to a hemosuccus pancreaticus secondary to the pseudoaneurysm of the splenic artery. An arteriography was performed to embolize it. Pseudoaneurysm of the splenic artery is a rare cause of gastrointestinal bleeding. Given the risk of a rupture, the treatment is mandatory irrespective of the size or symptoms...
September 22, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28935009/acute-occlusion-of-the-abdominal-aorta-with-sudden-paraplegia-in-a-captive-mustached-tamarin-saguinus-mystax
#4
Carmen R Michaud, Richard Herbert, William R Elkins, Alfonso S Gozalo
A wild-caught, research-naïve, adult male mustached tamarin (Saguinus mystax) experienced sudden onset of bilateral hindlimb paresis. Physical examination established the presence of paralysis and the lack of femoral pulses and deep pain in both legs. There were no signs of external trauma and, due to a poor prognosis, euthanasia was elected. Necropsy findings included pleural effusion, partial pulmonary atelectasis and congestion, dilatatory cardiomyopathy, a renal hemorrhagic infarct, and a thromboembolus located at the trifurcation of the distal abdominal aorta...
October 1, 2017: Comparative Medicine
https://www.readbyqxmd.com/read/28934831/pneumoretroperitoneum-pneumomediastinum-pneumothorax-and-subcutaneous-emphysema-after-diagnostic-colonoscopy
#5
Hee Sung Lee, Hwan Hee Park, Ju Seok Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong
Colonoscopy is a commonly performed endoscopic procedure. Although it is generally considered to be safe, serious complications, such as colorectal perforation, can occur. Most colonic perforations are intraperitoneal and cause pneumoperitoneum with acute abdominal pain as the initial symptom. However, extraperitoneal perforations with pneumoretroperitoneum may happen, albeit rarely, with atypical initial symptoms. We report a rare case of rectosigmoid perforation occurring after diagnostic colonoscopy that developed into pneumoretroperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema, with a change in voice and neck swelling as the initial symptoms...
September 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28933137/rectal-perforation-in-a-42-year-old-woman-due-to-henoch-sch%C3%A3-nlein-purpura-a-case-report
#6
F Almassinokiani, A Mehdizadeh Kashi, A Musavi, S Khodaverdi, K Tahermanesh, S Ariana
Henoch-Schönlein purpura (HSP) is caused by deposition of IgA-containing immune complexes within the blood vessels. HSP mostly occurs in children and is less common in adults. In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children. These can be caused by gastrointestinal hemorrhage, bowel ischemia and necrosis, intussusception, and bowel perforation. In adults, intussusception is less frequent than in children. We report a 42-year-old woman referred to our hospital with acute abdominal pain...
September 21, 2017: Reumatismo
https://www.readbyqxmd.com/read/28932352/novel-technique-of-abdominal-wall-nerve-block-for-laparoscopic-colostomy-rectus-sheath-block-with-transperitoneal-approach
#7
Jun Nagata, Jun Watanabe, Yusuke Sawatsubashi, Masaki Akiyama, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Kotaro Hamada, Yoshifumi Nakayama, Keiji Hirata
A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel...
August 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28928658/anti-inflammatory-antinociceptive-and-antioxidant-activities-of-methanol-and-aqueous-extracts-of-anacyclus-pyrethrum-roots
#8
Houria Manouze, Otmane Bouchatta, A Chemseddoha Gadhi, Mohammed Bennis, Zahra Sokar, Saadia Ba-M'hamed
Anacyclus pyrethrum (L.) is a plant widely used in Moroccan traditional medicine to treat inflammatory and painful diseases. The objective of the present study was to evaluate the antinociceptive, anti-inflammatory and antioxidant activities of aqueous and methanol extracts of Anacyclus pyrethrum roots (AEAPR and MEAPR). The anti-inflammatory effect of AEAPR and MEAPR was determined in xylene-induced ear edema and Complete Freund's Adjuvant (CFA)-induced paw edema. The antinociceptive activity of AEAPR and MEAPR (125, 250, and 500 mg/kg) administered by gavage was examined in mice by using acetic acid-induced writhing, hot plate, and formalin tests, and the mechanical allodynia were assessed in CFA-induced paw edema...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28924279/value-of-leucine-rich-alpha-2-glycoprotein-1-lrg-1-on-diagnosis-of-acute-appendicitis-in-female-patients-with-right-lower-quadrant-abdominal-pain
#9
Osman Lutfi Demirci, Yunsur Cevik, Seref Kerem Corbacioglu, Alpaslan Taner
OBJECTIVE: To assess the diagnostic usefulness of leucine-rich alpha-2-glycoprotein-1 in female patients with acute abdominal pain on right lower-quadrant and acute appendicitis. METHODS: The prospective, cross-sectional study was conducted at the emergency department of Kecioren Training and Research Hospital, Ankara, Turkey, during a two-month period in 2014, and comprised patients with acute abdominal pain in right lower-quadrant, and control subjects. Female patients aged 18-60 years who were admitted to the hospital's emergency department were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28923678/a-case-report-on-gastric-volvulus-of-a-17-years-old-boy-from-bangladesh
#10
M Tasdik Hasan, S M Tajdit Rahman, Hasan M Shihab, Hassan Rushekh Mahmood, Tanni Chowdhury, Quamrul Akhtar Sanju
INTRODUCTION: Gastric volvulus is a rare and true surgical emergency which is life threatening if not recognized and treated quickly. There have been approximately 300 reported cases globally till now. This condition most often occurs during 5th decade of life but there are over 100 reported pediatric cases also. This following rare incidence was such a case of a young patient in Bangladesh. It was the first case of gastric volvulus managed by the surgery department of the concerned hospital...
September 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28921009/radiation-overexposure-from-repeated-ct-scans-in-young-adults-with-acute-abdominal-pain
#11
Massimo Tonolini, Elena Valconi, Angelo Vanzulli, Roberto Bianco
PURPOSE: The purpose of this study is to assess the dose of ionizing radiation caused by repeated CT scans performed to investigate non-traumatic acute abdominal conditions in young adults. METHODS: Over 26 months, we collected a cohort of patients aged 18 to 45 years who were subject to at least one urgent contrast-enhanced abdomen/pelvis CT. Patients affected with urolithiasis, HIV infection, tumors, and vascular and chronic inflammatory bowel diseases were excluded...
September 18, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28913814/child-with-abdominal-pain
#12
Rajalakshmi Iyer, Karthi Nallasamy
Abdominal pain is one of the common symptoms reported by children in urgent care clinics. While most children tend to have self-limiting conditions, the treating pediatrician should watch out for underlying serious causes like intestinal obstruction and perforation peritonitis, which require immediate referral to an emergency department (ED). Abdominal pain may be secondary to surgical or non-surgical causes, and will differ as per the age of the child. The common etiologies for abdominal pain presenting to an urgent care clinic are acute gastro-enteritis, constipation and functional abdominal pain; however, a variety of extra-abdominal conditions may also present as abdominal pain...
September 15, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28904459/clinical-biochemical-characteristics-and-hospital-outcome-of-acute-intermittent-porphyria-patients-a-descriptive-study-from-north-india
#13
Susheel Kumar, Ashish Bhalla, Navneet Sharma, Deba Prasad Dhibar, Savita Kumari, Subhash Varma
INTRODUCTION: Acute intermittent porphyria (AIP) is an inherited metabolic disease characterized by disordered heme biosynthesis. There is no recent study reported from India. MATERIALS AND METHODS: It was a retrospective, observational study. Clinical records of patients of AIP with acute porphyric attacks admitted from April 2008 to December 2016 were analyzed. RESULTS: Fifteen AIP patients constituted of eight females and seven males were analyzed...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28902786/diagnosing-chronic-pancreatitis-comparison-and-evaluation-of-different-diagnostic-tools
#14
Yama Issa, Hjalmar C van Santvoort, Susan van Dieren, Marc G Besselink, Marja A Boermeester, Usama Ahmed Ali
OBJECTIVES: This study aims to compare the M-ANNHEIM, Büchler, and Lüneburg diagnostic tools for chronic pancreatitis (CP). METHODS: A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute pancreatitis. We compared the individual components of the M-ANNHEIM, Büchler, and Lüneburg tools, the agreement between tools, and estimated diagnostic accuracy using Bayesian latent-class analysis...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28900861/acute-kidney-injury-caused-by-decompression-illness-successfully-treated-with-hyperbaric-oxygen-therapy-and-temporary-dialysis
#15
Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...
September 12, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28900659/delayed-presentation-of-uterine-rupture-in-a-didelphys-uterus-misdiagnosed-as-appendicitis-a-case-report-and-review-of-the-literature
#16
Linsen Shi, Xiaoman Lin, Suoyou Sha, Libin Yao, Xiaocheng Zhu, Yong Shao
INTRODUCTION: Uterine rupture during pregnancy caused by uterine dysplasia, such as the double uterus, is very rare and easily overlooked by the surgeon. CASE: A 25-year-old woman, at 17 weeks of gestation presented to our emergency center with acute right lower abdominal pain for more than 10 h. The initial diagnosis is acute appendicitis, but during the exploration, we found about 2500 mL of intraperitoneal hemorrhage, appendix was normal, pregnancy in one of the double uterine and ruptured at the right bottom...
September 12, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28900551/appendicitis-caused-by-primary-varicella-zoster-virus-infection-in-a-child-with-digeorge-syndrome
#17
Lotte Møller Smedegaard, Claus Bohn Christiansen, Linea Cecilie Melchior, Anja Poulsen
INTRODUCTION: Chickenpox is caused by varicella zoster virus (VZV). Although predominantly a mild disease, it can cause considerable morbidity and in rare occasions even mortality in healthy children as well as increased morbidity and mortality in immunocompromised patients. The aetiology of appendicitis is largely unknown but is thought to be multifactorial. Appendicitis is a suspected, but not well documented, complication from varicella zoster virus infection. CASE PRESENTATION: A five-year-old girl diagnosed with DiGeorge syndrome and a prolonged primary VZV infection was admitted due to abdominal pain, increasing diarrhoea, vomiting, and poor general condition...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28900333/ruptured-malignant-ovarian-tumor-in-an-adolescent-girl-a-rare-case-report
#18
Kanika Chopra, Swati Agrawal, Kiran Aggarwal, Ratna Biswas
Germ cell tumors which arise mainly in pediatric and adolescent age group, account for 30% of all ovarian tumors, but constitute only 5% of all malignant ovarian tumors. The presentation is usually insidious with the patient presenting with abdominal swelling and dull aching pain. We report a rare case of a malignant germ cell tumor in a 12-year-old girl who presented with acute abdomen due to spontaneous rupture of tumor resulting in hemoperitoneum. The patient was taken up for emergency laparotomy and left salpingo-opherectomy with omentectomy and drainage of hemoperitoneum was done...
April 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28899741/small-bowel-stenosis-a-manifestation-of-chronic-graft-versus-host-disease-in-children
#19
Mickael Tordjman, Marie Ouachee, Arnaud Bonnard, Bogdana Tilea, Karima Yakouben, Jerome Viala, Michel Peuchmaur, Dominique Berrebi
Digestive graft versus host disease (GVHD) is a frequent complication after bone marrow transplantation (BMT), but small bowel obstruction is an extremely rare event. We present herein the first pediatric series of 4 cases of small bowel obstruction after BMT with detailed gross, histological data and their genetic status of the NOD2 gene. All patients had a history of severe acute GVHD treated by immunosuppressive agents and/or infliximab (in 3 cases). Acute or progressively worsening abdominal pain accompanied by small bowel occlusion occurred 5-16months after graft and CT-scan revealed multiple small intestinal stenosis...
September 9, 2017: Human Pathology
https://www.readbyqxmd.com/read/28898791/overlooked-complication-of-anticoagulant-therapy-the-intramural-small-bowel-hematoma-a-case-report
#20
J M Pimenta, S Raluca, J Pimenta de Castro, L Gabriel Pereira
INTRODUCTION: Intramural small bowel hematoma is a rare, and often overlooked consequence of anticoagulant therapy. In this report we present such a case in order to bring forth awareness to this entity, and its management. PRESENTATION OF CASE: We report a 81-year old male who presented with abdominal pain for 2days. He had been under anticoagulant therapy with warfarin for 9 years, presenting with an elevated INR of 6,2. Intramural small bowel hematoma was confirmed with abdominal ultrasound and CT scan...
September 1, 2017: International Journal of Surgery Case Reports
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