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https://www.readbyqxmd.com/read/29764844/second-look-laparostomy-for-perforated-gangrenous-gastric-volvulus-to-prevent-total-gastrectomy
#1
Paul K Okeny, Omar Abbassi, Ali Warsi
A 42-year-old Caucasian woman presented to the emergency department with severe upper abdominal pain and vomiting. Clinically, she was septic, and abdominal examination suggested peritonitis. Following immediate resuscitation, the patient was stabilised and underwent urgent contrast-enhanced CT of the abdomen and pelvis. This revealed a mesenteroaxial gastric volvulus with traction on the mesentery and a small volume of free fluid. She underwent laparotomy revealing gangrenous gastric fundus perforation complicated by persistent intraoperative hypotension...
May 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29757718/us-of-right-upper-quadrant-pain-in-the-emergency-department-diagnosing-beyond-gallbladder-and-biliary-disease
#2
Gayatri Joshi, Kevin A Crawford, Tarek N Hanna, Keith D Herr, Nirvikar Dahiya, Christine O Menias
Acute cholecystitis is the most common diagnosable cause for right upper quadrant abdominal (RUQ) pain in patients who present to the emergency department (ED). However, over one-third of patients initially thought to have acute cholecystitis actually have RUQ pain attributable to other causes. Ultrasonography (US) is the primary imaging modality of choice for initial imaging assessment and serves as a fast, cost-effective, and dynamic modality to provide a definitive diagnosis or a considerably narrowed list of differential possibilities...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29757367/successful-total-endovascular-repair-of-a-giant-salmonella-infected-painful-thoraco-abdominal-aortic-pseudoaneurysm
#3
Nellie Della Schiava, Matthieu Arsicot, Mathias Montveneur, Antoine Millon
Endovascular approach is now a safe and effective technique for the elective treatment of a thoraco-abdominal aneurysm. This technique has significantly reduced the morbi-mortality for elective surgery. Moreover, it can permit to treat patients with a high surgical risk who are not eligible for open surgery. The permanent availability of endovascular material opens the door for treating a complex emergency thoraco-abdominal aneurysm. Here, we present the case of an 81-year-old man who had a rapidly evolving salmonella-infected aortic thoraco-abdominal Type IV pseudoaneurysm...
May 10, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29755017/endoscopic-papillectomy-of-benign-ampullary-lesions-outcomes-from-a-multicenter-study
#4
Tan Attila, Erkan Parlak, Emrah Alper, Selçuk Dişibeyaz, Bahattin Çiçek, Bülent Ödemiş
BACKGROUND/AIMS: Endoscopic papillectomy (EP) has emerged as an alternative to surgery in the management of ampullary lesions. The aim of this study is to evaluate feasibility, efficacy, safety, outcome, and impact of EP in the management of benign ampullary lesions. MATERIALS AND METHODS: This is a multicenter, retrospective study of 44 patients who had EP of benign ampullary lesions. RESULTS: Over the 11-year period, 44 (55.7%) of 79 patients underwent EP for benign ampullary lesions...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29753277/amyand-s-hernia-a-case-report-and-review-of-the-literature
#5
Youssef Shaban, Adel Elkbuli, Mark McKenney, Dessy Boneva
INTRODUCTION: An Amyand hernia is a rare disease where the appendix is found within an inguinal hernia sac. This rare entity is named after the French born English surgeon, Dr. Claudius Amyand. Inguinal hernias are one of the most common surgeries that a general surgeon performs with more than 20 million inguinal hernia repairs performed yearly worldwide. The incidence of finding an appendix within the hernia sac is rare, occurring in less than 1% of inguinal hernia patients and when complications arise such as inflammation, perforation, or abscess formation it becomes exceptionally rare with an incidence of about 0...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29739764/left-sided-omental-infarction-a-rare-cause-of-abdominal-pain-discovered-by-ct-scan
#6
Jamie L G Nijkamp, Suzanne C Gerretsen, Patricia M Stassen
Omental infarction in adults is a rarely occurring phenomenon, with left-sided omental infarction being even more seldom. The importance of this case report lies in raising awareness of the diagnosis omental infarction as a cause of acute abdomen among doctors who work in the emergency department, in order to prevent unnecessary surgical interventions as conservative treatment generally solves the problem. Omental infarction is the result of vascular obstruction and ends in tissue ischaemia. Because of the rich vasculature of the greater omentum, anastomoses reorganise the vascularisation, which explains the mostly benign course of omental infarction...
May 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29738103/bedside-sonography-performed-by-emergency-physicians-to-detect-appendicitis-in-children
#7
Marie Nicole, Marie Pier Desjardins, Jocelyn Gravel
OBJECTIVE: The aim of this study was to evaluate the ability of emergency physicians with various levels of Point of Care Ultrasound (POCUS) experience to detect appendicitis with POCUS among children visiting a pediatric Emergency Department (ED). METHODS: A prospective cohort study was conducted in an urban, tertiary care pediatric ED. Children aged 2 to 18 years old who presented with acute abdominal pain suggesting appendicitis were included. Patients were excluded if they had a history of appendectomy, hemodynamic instability requiring resuscitation, or were transferred with proven diagnosis of appendicitis...
May 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29706482/pain-in-pancreatic-ductal-adenocarcinoma-a-multidisciplinary-international-guideline-for-optimized-management
#8
REVIEW
Asbjørn M Drewes, Claudia M Campbell, Güralp O Ceyhan, Myriam Delhaye, Pramod K Garg, Harry van Goor, Berta Laquente, Bart Morlion, Søren S Olesen, Vikesh K Singh, Per Sjøgren, Eva Szigethy, John A Windsor, Marina G Salvetti, Rupjyoti Talukdar
Abdominal pain is an important symptom in most patients with pancreatic ductal adenocarcinoma (PDAC). Adequate control of pain is often unsatisfactory due to limited treatment options and significant variation in local practice, emphasizing the need for a multidisciplinary approach. This review contends that improvement in the management of PDAC pain will result from a synthesis of best practice and evidence around the world in a multidisciplinary way. To improve clinical utility and evaluation, the evidence was rated according to the GRADE guidelines by a group of international experts...
April 22, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29692890/management-of-a-postbulbar-duodenal-ulcer-and-stricture-causing-gastric-outlet-obstruction-a-case-report
#9
Maxwell D Mirande, Raul A Mirande
Introduction: Peptic ulcer disease has significantly decreased over the past several decades making the need for definitive surgical intervention an infrequent occurrence. Presentation of Case: A 44-year-old Caucasian female was sent to the emergency department by her primary care physician for right upper quadrant abdominal pain which had been intermittent for the past two months but acutely worsened over the last five days. During this time, she was unable to tolerate oral intake with intractable nausea and vomiting...
May 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29676706/-a-man-with-abdominal-pain-diarrhoea-and-rectal-bleeding
#10
A J M Oosterwijk, J W van den Berg, C C van Rossem
A 49-year-old man came to the emergency room with abdominal pain, vomiting, diarrhoea and rectal bleeding. Both colonoscopy and CT of the abdomen showed cecocolic intussusception caused by an appendiceal mucocele. An ileocecal resection was performed via a laparoscopic approach and microscopy of the tissue showed a low-grade mucinous neoplasm.
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29675635/intussusception-after-roux-en-y-gastric-bypass-laparoscopic-management
#11
Enrico Facchiano, Emanuele Soricelli, Luca Leuratti, Viviana Caputo, Giovanni Quartararo, Marcello Lucchese
INTRODUCTION: Intussusception represents an uncommon cause of intestinal obstruction after Rouxen-Y gastric bypass. Symptoms are not specific and clinical presentation may vary from acute intestinal obstruction with or without bowel necrosis to intermittent or chronic pain. CT scan is the diagnostic test of choice. MATERIALS AND METHODS: A 38-year-old woman who had undergone RYGBP 5 months prior was admitted to our Emergency Department with acute abdominal pain, alimentary and bilious vomiting, and fever...
April 19, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29628547/ultrasound-guided-combined-fascial-plane-blocks-as-an-intervention-for-pain-management-after-laparoscopic-cholecystectomy-a-randomized-control-study
#12
Seshadri Ramkiran, Mathews Jacob, Manish Honwad, Desiraju Vivekanand, Mathangi Krishnakumar, Seema Patrikar
Background: Pain associated with laparoscopic cholecystectomy is most severe during the first 24 h and the port sites are the most painful. Recent multimodal approaches target incisional pain instead of visceral pain which has led to the emergence of abdominal fascial plane blocks. This study embraces a novel combination of two independently effective fascial plane blocks, namely rectus sheath block and subcostal transversus abdominis plane (TAP) block to alleviate postoperative pain...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29540635/midline-extraperitoneal-approach-for-obturator-hernia-repair
#13
Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike
Obturator hernia (OH) is a rare condition that accounts for 0.073-1% of abdominal hernias and 0.48% of bowel obstructions. OH frequently occurs in elderly women, with an incidence that increases with age. The only treatment for OH is surgical intervention, and the approaches used vary greatly. Consequently, a well-defined consensus has not yet emerged. We assessed the efficiency and safety of the midline extraperitoneal approach for OH. Six patients with OH repaired using the midline extraperitoneal approach at KKR Sapporo Medical Center between April 2011 and January 2016 were included in the study...
March 14, 2018: Keio Journal of Medicine
https://www.readbyqxmd.com/read/29515707/infrarenal-abdominal-aortic-pseudoaneurysm-is-it-a-real-emergency
#14
Mafalda Massara, Roberto Prunella, Pasquale Gerardi, Antonio Lillo, Giovanni De Caridi, Raffaele Serra, Stefano Notarstefano, Giovanni Impedovo
Abdominal aortic pseudoaneurysm is a rare but life-threatening condition that occurs due to penetrating or blunt trauma. Clinical manifestations are variable, and the time interval from the initial trauma to diagnosis is variable. A prompt diagnosis and an aggressive management approach are required to avoid catastrophic complications. Possible treatment options are open surgical repair, endovascular repair, pseudoanerysmal sac thrombosis induction through direct thrombin injection, and coil embolization. Here, we present the case of a 75-year-old man affected by an infrarenal abdominal aortic pseudoaneurysm presenting with abdominal and lumbar pain for 3 days, who was successfully treated with an endograft...
December 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29511263/the-use-of-metabolomics-and-inflammatory-mediator-profiling-provides-a-novel-approach-to-identifying-pediatric-appendicitis-in-the-emergency-department
#15
Nusrat S Shommu, Craig N Jenne, Jaime Blackwood, Dori-Ann Martin, Ari R Joffe, Robin Eccles, Mary Brindle, Ijab Khanafer, Hans J Vogel, Graham C Thompson
Multiplexed profiling approaches including various 'omics' platforms are becoming a new standard of biomarker development for disease diagnosis and prognosis. The present study applied an integrated metabolomics and cytokine profiling approach as a potential aid to the identification of pediatric appendicitis. Metabolic analysis using serum (n = 121) and urine (n = 102) samples, and cytokine analysis using plasma (n = 121) samples from children presenting to the Emergency Department with abdominal pain were performed...
March 6, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29504327/dengue-knowledge-in-indoor-dengue-patients-from-low-socioeconomic-class-aetiology-symptoms-mode-of-transmission-and-prevention
#16
Nadia Shams, Sadia Amjad, Nadeem Yousaf, Waqar Ahmed, Naresh Kumar Seetlani, Shazia Farhat
BACKGROUND: Dengue fever has emerged as an emerging public health issue during last decade bearing significant morbidity and economic burden particularly in third world countries. Current study aims to assess various domains of knowledge of indoor dengue patients.. METHODS: This descriptive crosssectional study was conducted at Medicine dept. Rawal Institute of Health Sciences Islamabad and BBH Rawalpindi over 6 months. One hundred & twenty-five adult indoor confirmed cases of dengue from lower socioeconomic class were included after ethical approval...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29497992/the-management-of-paediatric-functional-abdominal-pain-disorders-latest-evidence
#17
REVIEW
Andrea Brusaferro, Edoardo Farinelli, Letizia Zenzeri, Rita Cozzali, Susanna Esposito
Recurrent abdominal pain (RAP) is one of the most common health complaints in both children and adults. Although RAP is considered a functional disorder rather than an organic disease, affected children and their families can still experience anxiety and concerns that can interfere with school, sports, and regular daily activities and lead to frequent attendances at pediatric emergency departments or pediatric gastroenterology clinics. Our review shows experts do not agree on a universally proven management that will work on every child presenting with functional abdominal pain (FAP)...
March 2, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29477925/intestinal-obstruction-caused-by-endometriosis-endoscopic-stenting-and-expedited-laparoscopic-resection-avoiding-stoma-a-case-report-and-review-of-the-literature
#18
Pietro Calcagno, Matteo Viti, Alessandro Cornelli, Davide Galli, Corrado D'Urbano
INTRODUCTION: Endometriosis is the growth of endometrium outside the uterine cavity. In 5-15% of cases the disease can affect the colon and small bowel, causing complete obstruction and requiring resection in about 1% of cases. CASE SUMMARY: We describe a case of sigmoid obstruction due to endometriosis in a 38 years old woman with personal history of endometriosis. She was admitted for abdominal pain and constipation. The patient was treated with endoscopic stenting and subsequent laparoscopic sigmoidectomy...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29443696/intravenous-lidocaine-for-intractable-renal-colic-unresponsive-to-standard-therapy
#19
Billy Sin, John Cao, David Yang, Karen Ambert, Sheena Punnapuzha
CLINICAL FEATURES: Renal colic is defined as a flank pain radiating to the groin caused by kidney stones in the ureter (urolithiasis). Renal colic is a frequent cause of Emergency Department visits. Most renal colic cases present as acute distress and severe back and/or abdominal pain that require prompt treatment with analgesics. THERAPEUTIC CHALLENGE: Nonsteroidal anti-inflammatory drugs and opioids are traditionally used for renal colic in the Emergency Department...
January 23, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29393040/perioperative-treatment-of-patients-undergoing-acute-high-risk-abdominal-surgery
#20
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
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