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https://www.readbyqxmd.com/read/28105581/point-of-care-ultrasound-identification-of-pneumatosis-intestinalis-in-pediatric-abdominal-pain-a-case-report
#1
Vigil James, Aswin Warier, Khai Pin Lee, Gene Yong-Kwang Ong
We describe a case report of an infant with intussusception who presented to a pediatric emergency department with diarrhea and increased irritability. Pneumatosis intestinalis (intra-mural air) detected on point-of-care ultrasonography (but not apparent on plain abdominal radiographs) alerted the emergency physicians towards the severity of disease process.
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28104992/ileo-ileal-intussusception-caused-by-lymphangioma-of-the-small-bowel-treated-by-single-incision-laparoscopic-assisted-ileal-resection
#2
Atsushi Kohga, Akihiro Kawabe, Yuto Hasegawa, Kiyoshige Yajima, Takuya Okumura, Kimihiro Yamashita, Jun Isogaki, Kenji Suzuki, Akira Komiyama
Intraabdominal lymphangiomas are uncommon; additionally, those affecting the gastrointestinal tract are rare and account for less than 1% of cases. Intussusception caused by a cystic lymphangioma of the small bowel is extremely rare. The patient was a 20-year-old woman who visited our emergency room with a complaint of abdominal pain. A computed tomography image revealed ileo-ileal intussusception with a leading hypovascular mass measuring 1 cm in a diameter. Single-incision laparoscopic-assisted ileal resection was performed...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28104974/rare-manifestation-of-digoxin-toxicity-right-bundle-branch-block
#3
Dalvir Gill, Samana Zaidi
A 76-year-old female, with medical history significant for systolic congestive heart failure, who presented to the emergency department with lethargy and abdominal pain with diarrhea for the past 3 weeks. Due to hypotension, the patient received multiple boluses of isotonic saline and was started on norepinephrine. Laboratories were significant for severe digoxin toxicity (29 ng/mL), in setting of acute kidney injury. Electrocardiogram (EKG) revealed a new right bundle branch block (RBBB). She was given Digibind and her repeat digoxin level was 20 ng/mL...
December 2016: Journal of Basic and Clinical Pharmacy
https://www.readbyqxmd.com/read/28104973/unusual-case-of-an-alcoholic-with-liver-injury-from-sulfasalazine-use
#4
Umair Masood, Anuj Sharma, Sonny Nijjar, Barbara Krenzer
A 57-year-old male with a history of alcoholism presented to the emergency room with abdominal pain, jaundice, transaminitis, and hyperbilirubinemia. Due to the history of alcoholism, it was initially presumed that the patient had alcoholic hepatitis but further investigation revealed that he was recently started on sulfasalazine for the treatment of rheumatoid arthritis. Upon cessation of the drug, the patient's liver function tests significantly improved over a few days and eventually normalized within weeks...
December 2016: Journal of Basic and Clinical Pharmacy
https://www.readbyqxmd.com/read/28103732/evaluation-of-antivenom-therapy-for-vipera-palaestinae-bites-in-children-experience-of-two-large-tertiary-care-pediatric-hospitals
#5
Dikla Pivko-Levy, Itamar Munchnak, Ayelet Rimon, Uri Balla, Dennis Scolnik, Christopher Hoyte, Yair Voliovitch, Miguel Glatstein
BACKGROUND: Antivenom has been successfully used to treat systemic and progressive, local manifestations of envenomation inflicted by Vipera (V.) palaestinae, the most common venomous snake in Israel. The objective of this study was to evaluate the fixed dose V. palaestinae monovalent (equine) immunoglobulin G antivenom used in two pediatric emergency departments. In particular, we wanted to assess the need for repeated antivenom administration and the rate of adverse antivenom effects in children...
January 20, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28102481/perforation-of-jejunal-diverticulum-with-ectopic-pancreas
#6
Hiroshi Shiratori, Takeshi Nishikawa, Yukako Shintani, Koji Murono, Kazuhito Sasaki, Koji Yasuda, Kensuke Otani, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Kazushige Kawai, Hiroaki Nozawa, Soichiro Ishihara, Masashi Fukayama, Toshiaki Watanabe
Perforation of jejunal diverticulum is a rare complication. Here, we report a case of jejunal diverticulum penetration with surrounding ectopic pancreas. An 83-year-old female patient was admitted to our department with acute onset of severe abdominal pain lasting for half a day. Abdominal computed tomography showed outpouching of the small intestine that contained air/fluid, with multiple surrounding air bubbles in the mesentery of the small intestine. She was diagnosed with penetration of the small intestine, and an emergency laparotomy was indicated...
January 19, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28100994/reocclusion-after-self-expandable-metallic-stent-placement-for-relieving-malignant-colorectal-obstruction-as-a-palliative-treatment
#7
Toshikatsu Nitta, Kensuke Fujii, Yoshimasa Hirata, Tomo Tominaga, Yoshihiro Inoue, Hiroshi Kawasaki, Ken Kawakami, Takashi Ishibashi
Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100060/boerhaave-s-syndrome-diagnostic-gastroscopy
#8
Rocío Ferreiro-Iglesias, Manuel Narciso Blanco Freire, Manuel Paz Novo, J Enrique Domínguez Muñoz
A 47-year-old man was attended at the emergency room for severe chest pain after eating sausage with subsequent vomiting and mild upper gastrointestinal bleeding. In the chest radiography we could not see abnormalities. He referred previous episodes of choking without consulting. The urgent gastroscopy detected tertiary contractile activity (nutcracker esophagus) and a foreign body in the lower third of the esophagus. After removing the food bolus, we observed a 4 cm longitudinal tear compatible with esophageal rupture or Boerhaave's syndrome in the right posterior wall of the lower esophagus, proximal to the gastroesophageal junction...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28098574/new-developments-in-robotics-and-single-site-gynecologic-surgery
#9
Catherine A Matthews
Within the last 10 years there have been significant advances in minimal-access surgery. Although no emerging technology has demonstrated improved outcomes or fewer complications than standard laparoscopy, the introduction of the robotic surgical platform has significantly lowered abdominal hysterectomy rates. While operative time and cost were higher in robotic-assisted procedures when the technology was first introduced, newer studies demonstrate equivalent or improved robotic surgical efficiency with increased experience...
January 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28098112/autosomal-dominant-polycystic-kidney-disease-study-of-clinical-characteristics-in-an-indian-population
#10
Sanjay Vikrant, Anupam Parashar
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary form of kidney disease. Clinical data on this multisystem disorder are scarce from developing countries. We conducted a prospective observational study of the clinical profile of ADPKD patients at a single center over a period of six years. A total of 208 patients were studied. Majority were male (60.6%) and the mean age was 45.8 ± 14.5 years. About 61.5% had early stage (Stages 1-3) of chronic kidney disease (CKD) and 38.5% had advanced CKD (Stages 4 and 5)...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28096327/pneumatosis-coli-causing-pneumoperitoneum
#11
Jennifer M Nishimura, Ted Farzaneh, Alessio Pigazzi
This is a case of a 54-year-old gentleman who presented to an outside hospital emergency department with lower abdominal pain. Computed tomography imaging showed a small amount of intraperitoneal free air and cystic pneumatosis coli. He was admitted, managed conservatively with intravenous antibiotics, and then discharged home after his symptoms improved. Elective laparoscopic sigmoid colectomy was subsequently performed with intraoperative findings of partial sigmoid volvulus and extensive pneumatosis coli of the sigmoid colon...
January 17, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28096306/national-multicentre-audit-of-pregnancy-status-in-general-surgery-admissions-in-scotland
#12
Michael S J Wilson, Matilda Powell-Bowns, Andrew G Robertson, Andreas Luhmann, Colin H Richards
BACKGROUND: Documentation of pregnancy status (PS) is an integral component of the assessment of women of reproductive age when admitted to hospital. Our aim was to determine how accurately PS was documented in a multicentre audit of female admissions to general surgery. METHODS: A prospective multicentre audit of elective and emergency admissions was performed in 18 Scottish centres between 08:00 on 11 May 2015 and 07:59 on 25 May 2015. The lower age limit was the minimum age for admission to the adult surgical ward and the upper age limit was 55 years...
January 17, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28093873/diagnostic-and-management-challenges-from-childhood-puberty-through-to-transition-in-severe-insulin-resistance-due-to-insulin-receptor-mutations
#13
Christina Wei, Christine P Burren
Two Caucasian girls, both of normal weight and body mass indices, were diagnosed with type A insulin resistance (IR) in childhood. Case 1 presented with premature adrenarche aged 7 years, then by age 12 years had hirsutism, acne, acanthosis nigricans, and asymptomatic diabetes. Subsequent investigation revealed raised adiponectin (15.3 mg/L) and heterozygous p.Pro1205Leu mutation in the INSR gene encoding the insulin receptor. She experienced postprandial hypoglycaemia on metformin; acarbose was trialled and discontinued aged 16 years, as she became normoglycaemic...
January 17, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28089100/community-onset-clostridium-difficile-infection-at-a-tertiary-medical-center-in-southern-taiwan-2007-2015
#14
Chin-Shiang Tsai, Yuan-Pin Hung, Jen-Chieh Lee, Nan-Yao Lee, Po-Lin Chen, Ling-Shan Syue, Ming-Chi Li, Chia-Wen Li, Wen-Chien Ko
BACKGROUND: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. METHODS: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI)...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#15
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28075619/role-of-ct-in-the-diagnosis-of-nonspecific-abdominal-pain-a-multicenter-analysis
#16
Jonathan D Eisenberg, Andrew T Reisner, William D Binder, Atif Zaheer, Martin L Gunn, Ken F Linnau, Chad M Miller, Angela C Tramontano, Maurice S Herring, Emily C Dowling, Elkan F Halpern, Karen Donelan, G Scott Gazelle, Pari V Pandharipande
OBJECTIVE: The objective of our study was to determine whether specific patient and physician factors-known before CT-are associated with a diagnosis of nonspecific abdominal pain (NSAP) after CT in the emergency department (ED). MATERIALS AND METHODS: We analyzed data originally collected in a prospective multicenter study. In the parent study, we identified ED patients referred to CT for evaluation of abdominal pain. We surveyed their physicians before and after CT to identify changes in leading diagnoses, diagnostic confidence, and admission decisions...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#17
Margarita Rivas M, Pamela Belmar Z, Pilar Durruty A, Lilian Sanhueza M, Gloria López S
Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28074453/laparoscopic-resection-and-intracorporeal-anastomosis-of-perforated-small-bowel-caused-by-fish-bone-ingestion
#18
Ahmet Cem Dural, Muhammet Ferhat Çelik, Hakan Yiğitbaş, Cevher Akarsu, Mahmut Doğan, Halil Alış
Presently described is case of a 52-year-old man who was admitted to the emergency department with 3-day history of epigastric pain. Abdominal examination revealed diffuse tenderness and muscle guarding. Plain abdominal X-ray showed free subdiaphragmatic air. The patient underwent diagnostic laparoscopy with presumptive diagnosis of peptic ulcer perforation. Laparoscopy showed several inflamed, edematous jejunal loops with proximal obstruction and perforation by an impacted fish bone. Completely intracorporeal resection and anastomosis using laparoscopic linear stapler was performed and segment of resected bowel was removed through trocar site...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28073942/emergency-department-visits-related-to-functional-abdominal-pain-in-the-pediatric-age-group
#19
Chaitanya Pant, Abhishek Deshpande, Thomas J Sferra, Mojtaba Olyaee
To analyze visits to and admissions from the emergency department (ED) in children with a primary diagnosis of functional abdominal pain (FAP). This was a cross-sectional study using data from the Nationwide Emergency Department Sample (HCUP-NEDS 2008-2012). FAP-related ED visits were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The most frequent secondary diagnoses associated with FAP-related ED visits were also extracted. In 2012, a total of 796,665 children presented to the ED with a primary diagnosis of FAP...
January 10, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28072475/safety-of-sulfur-hexafluoride-microbubbles-in-sonography-of-abdominal-and-superficial-organs-retrospective-analysis-of-30-222-cases
#20
Chunlin Tang, Kejing Fang, Yanli Guo, Rui Li, Xiaozhou Fan, Ping Chen, Zhaohui Chen, Qiangwei Liu, Ye Zou
OBJECTIVES: The purpose of this study was to investigate the safety of the sulfur hexafluoride microbubble contrast agent SonoVue (Bracco SpA, Milan, Italy) and to implement precautions with the intent of further improving the safety of this contrast agent. METHODS: A total of 30,222 patients undergoing contrast-enhanced sonography of abdominal and superficial organs in our hospital from January 2005 to December 2014 were retrospectively investigated. SonoVue was used as the ultrasound contrast agent...
January 10, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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