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https://www.readbyqxmd.com/read/29323836/segmental-arterial-mediolysis-an-unusual-case-mistaken-to-be-a-strangulated-hernia
#1
Russell D Japikse, James E Sevenson, Perry J Pickhardt, Michael D Repplinger
INTRODUCTION: Segmental arterial mediolysis (SAM) is a rare nonatherosclerotic, noninflammatory vasculopathy causing arterial wall necrosis that leads to strictures, dissections, and aneurysms, particularly in medium-sized abdominal arteries. Awareness of SAM is important because, unlike vasculitides, immunosuppressive treatment may worsen the disease process. CASE: A 58-year-old man with multiple medical comorbidities presented with acute epigastric pain and a right incarcerated inguinal hernia that was interpreted as showing bowel strangulation on computed tomography...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29303111/chronic-implantation-of-cuff-electrodes-on-the-pelvic-nerve-in-rats-is-well-tolerated-and-does-not-compromise-afferent-or-efferent-fibre-functionality
#2
Jonathan J Crook, Charly Brouillard, Pedro Irazoqui, Thelma Lovick
Objective Neuromodulation of autonomic nerve activity to regulate physiological processes is an emerging field. Vagal stimulation has received most attention whereas the potential of modulate visceral function by targeting autonomic nerves within the abdominal cavity remains under-exploited. Surgery to locate intra-abdominal targets is inherently more stressful than for peripheral nerves. Electrode leads risk becoming entrapped by intestines and loss of functionality in the nerve-target organ connection could result from electrode migration or twisting...
January 5, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29274599/bowel-obstruction-in-obturator-hernia-a-challenging-diagnosis
#3
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/29258479/surgical-treatment-strategies-for-giant-inguinoscrotal-hernia-a-case-report-with-review-of-the-literature
#4
Julia Isabelle Staubitz, Peter Gassmann, Daniel Wilhelm Kauff, Hauke Lang
BACKGROUND: An inguinoscrotal hernia is defined as "giant" if descending below the midpoint of the inner thigh of a patient in upright position. In developed countries this is a rare entity. In the literature different surgical techniques have been reported so far to achieve a successful treatment. CASE PRESENTATION: We present the case of a 63 year-old man suffering from a giant inguinoscrotal hernia, whom we treated using a combined open transabdominal and inguinal approach following an unsuccessful laparoscopic attempt...
December 19, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29233583/diagnostic-approach-to-the-acute-abdomen
#5
REVIEW
Gilles Fecteau, André Desrochers, David Francoz, Sylvain Nichols
The acute abdomen is a term used to characterize an animal presented as an emergency, in a more or less severe critical state, and for which medical and possibly surgical treatment will be necessary. To succeed, the clinician should use a systematic approach, have an excellent knowledge of the bovine abdominal anatomy, and have a good understanding of the pathophysiology of abdominal pain. Good clinical judgment, critical analysis, and good client communication skills are also essential. This article presents and discusses those necessary skills in the context of field practice...
December 9, 2017: Veterinary Clinics of North America. Food Animal Practice
https://www.readbyqxmd.com/read/29184050/a-rare-case-of-bochdalek-hernia-with-concomitant-para-esophageal-hernia-repaired-laparoscopically-in-an-octogenarian
#6
Sergio Susmallian, Asnat Raziel
BACKGROUND A Bochdalek hernia (BH) is a rare congenital condition consisting of a posterolateral defect in the diaphragm. A para-esophageal hernia (PEH) is a rare variant of hiatus hernia. BH and PEH may present with gastric volvulus or incarceration, requiring emergency treatment. Minimally invasive surgery is the preferred treatment, particularly for elderly patients and patients with comorbidities. The occurrence of BH with concomitant PEH is a very rare event. We describe a case of an octogenarian patient with BH and concomitant PEH treated laparoscopically...
November 29, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29163731/acute-abdominal-pain-assessment-in-the-emergency-department-the-experience-of-a-greek-university-hospital
#7
Dimitrios Velissaris, Menelaos Karanikolas, Nikolaos Pantzaris, George Kipourgos, Vasileios Bampalis, Konstantina Karanikola, Eleftheria Fafliora, Christina Apostolopoulou, Charalampos Gogos
Background: Acute abdominal pain (AAP) is a common symptom in the emergency department (ED). Because abdominal pain can be caused by a wide spectrum of underlying pathology, evaluation of abdominal pain in the ED requires a comprehensive approach, based on patient history, physical examination, laboratory tests and imaging studies. The aim of this study was to investigate predictive factors for admission to the hospital in patients who presented to the ED with AAP as the main symptom...
December 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29147570/management-of-an-acute-catecholamine-induced-cardiomyopathy-and-circulatory-collapse-a-multidisciplinary-approach
#8
R T Casey, B G Challis, D Pitfield, R M Mahroof, N Jamieson, C J Bhagra, A Vuylsteke, S J Pettit, K C Chatterjee
A phaeochromocytoma (PC) is a rare, catecholamine-secreting neuroendocrine tumour arising from the adrenal medulla. Presenting symptoms of this rare tumour are highly variable but life-threatening multiorgan dysfunction can occur secondary to catecholamine-induced hypertension or hypotension and subsequent cardiovascular collapse. High levels of circulating catecholamines can induce an acute stress cardiomyopathy, also known as Takotsubo cardiomyopathy. Recent studies have focused on early diagnosis and estimation of the prevalence of acute stress cardiomyopathy in patients with PC, but very little is reported about management of these complex cases...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29098095/medical-approach-to-right-colon-diverticulitis-with-perforation
#9
James Espinosa, Rahul Sharma, Alan Lucerna, Doug Stranges
We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29077648/initial-pain-management-in-pediatric-acute-pancreatitis-opioid-vs-non-opioid
#10
Amit S Grover, Paul D Mitchell, Shannon F Manzi, Victor L Fox
Nearly all patients with acute pancreatitis (AP) experience some degree of abdominal pain that is severe enough to prompt medical evaluation and necessitate analgesia. Effective analgesia is a priority in caring for such patients. Despite its importance, strategies for pain management in AP have been poorly studied, particularly in the field of pediatrics. Currently, no published data examine the management of pain due to acute pancreatitis in children at the time of initial presentation. Management approaches are often extrapolated from adult practice and based on anecdotal experience in the absence of objective data...
October 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29033764/non-meckel-small-intestine-diverticulitis
#11
Shamim Ejaz, Raghu Vikram, John R Stroehlein
Non-Meckel small intestine diverticulitis can have many manifestations and its management is not well-defined. We report 4 unselect cases of small intestine diverticulitis; all patients were seen by the same physician at the Emergency Center at The University of Texas MD Anderson Cancer Center between 1999 and 2014. The median age at diagnosis of these patients was 82 years (range, 76-87 years). All 4 patients presented with acute onset of abdominal pain, and computed tomography scans showed characteristics of small intestine diverticulitis unrelated to cancer...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29031895/chronic-pelvic-pain-in-an-interdisciplinary-setting-1-year-prospective%C3%A2-cohort
#12
Catherine Allaire, Christina Williams, Sonja Bodmer-Roy, Sean Zhu, Kristina Arion, Kristin Ambacher, Jessica Wu, Ali Yosef, Fontayne Wong, Heather Noga, Susannah Britnell, Holly Yager, Mohamed A Bedaiwy, Arianne Y Albert, Sarka Lisonkova, Paul J Yong
BACKGROUND: Chronic pelvic pain affects ∼15% of women, and presents a challenging problem for gynecologists due to its complex etiology involving multiple comorbidities. Thus, an interdisciplinary approach has been proposed for chronic pelvic pain, where these multifactorial comorbidities can be addressed by different interventions at a single integrated center. Moreover, while cross-sectional studies can provide some insight into the association between these comorbidities and chronic pelvic pain severity, prospective longitudinal cohorts can identify comorbidities associated with changes in chronic pelvic pain severity over time...
October 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29030793/right-sided-bochdalek-hernia-in-an-elderly-adult-a-case-report-with-a-review-of-surgical-management
#13
Kazuki Moro, Mikako Kawahara, Yusuke Muneoka, Yu Sato, Chie Kitami, Shigeto Makino, Atsushi Nishimura, Yasuyuki Kawachi, Emmanuel Gabriel, Keiya Nikkuni
BACKGROUND: Bochdalek hernias are one of the most common types of diaphragmatic hernia, with most cases diagnosed during the neonatal period. In contrast, diagnosis of a Bochdalek hernia in an adult is rare and is typically observed on the left side of the diaphragm. Even more rare is the diagnosis of a right-sided Bochdalek hernia in an adult, where there is concurrent visceral malformation in most cases. CASE PRESENTATION: We describe a case of an 89-year-old female who presented with abdominal pain...
October 13, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28932352/novel-technique-of-abdominal-wall-nerve-block-for-laparoscopic-colostomy-rectus-sheath-block-with-transperitoneal-approach
#14
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/28918297/a-rare-case-of-spontaneous-rupture-of-an-aneurysm-of-the-right-gastric-artery
#15
Yu-Ki Takemoto, Nobuaki Fujikuni, Kazuaki Tanabe, Hironobu Amano, Toshio Noriyuki, Masahiro Nakahara
BACKGROUND: Visceral artery aneurysms at the origin of the gastric and gastroepiploic artery are uncommon. Raptured visceral aneurysms cause high mortality and require urgent and adequate intervention and treatment. PRESENTATION OF CASE: A 65-year-old woman was transferred to the emergency department with sudden abdominal and back pain. Radiographically, we diagnosed intra-abdominal bleeding due to a ruptured aneurysm of the right gastric artery. Although her vital signs were relatively stable, transcatheter arterial embolization (TAE) could not be performed due to thrombotic occlusion of her abdominal aorta, and bilateral axillary arteries...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28898799/rare-diagnosis-of-intestinal-lipomatosis-complicated-by-intussusception-in-an-adult-a-case-report
#16
Kaitlin Kumar, Mahboub R Noori, Kishan M Patel, William Yuen, Carlos Bello
INTRODUCTION: Intestinal Lipomatosis consists of diffuse lipomas in various regions from the small to large bowel. They can remain asymptomatic or present with complications such as Intussusception. DISCUSSION: Intestinal lipomatosis complicated by Intussusception is a rare occurrence that has not been well documented. Rare condition management is difficult to approach because of the customizability each scenario requires. We hope through sharing our approach this can serve as a rough template to physicians who find themselves in a similar scenario...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28883275/successful-management-of-intraperitoneal-bleeding-with-platelet-apheresis-and-von-willebrand-factor-supplementation-in-a-patient-with-essential-thrombocythemia-and-acquired-von-willebrand-syndrome
#17
Toshimitsu Ueki, Kanako Takeshige, Masahiko Sumi, Mayumi Ueno, Naoaki Ichikawa, Hikaru Kobayashi
A 36-year-old woman with essential thrombocythemia (ET) was admitted to our hospital for acute lower abdominal pain. Given no family history of bleeding disorder, she was diagnosed with acquired von Willebrand syndrome. Despite having a medical history of venous thrombosis, she had never been treated for ET because of her preferences. On admission, CT scan revealed massive hemorrhage in the ascending colon with the leakage of a contrast agent. Furthermore, a delayed enhancement of fluid collection in the Douglas fossa followingcontrast CT indicated bloody ascites...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28812175/a-prospective-non-randomized-controlled-multicenter-trial-comparing-appendectomy-and-conservative-treatment-for-patients-with-uncomplicated-acute-appendicitis-the-actuaa-study
#18
Mauro Podda, Fernando Serventi, Lorenzo Mortola, Stefano Marini, Danilo Sirigu, Michela Piga, Marcello Pisano, Massimiliano Coppola, Ferdinando Agresta, Francesco Virdis, Salomone Di Saverio, Nicola Cillara
PURPOSE: Acute appendicitis (AA) is among the most common causes of lower abdominal pain and admissions to the emergency department. Over the past 20 years, there has been a renewed interest in the conservative management of uncomplicated AA, and several studies demonstrated that an antibiotic-first strategy is a viable treatment option for uncomplicated AA. The aim of this prospective non-randomized controlled, multicenter trial is to compare antibiotic therapy and emergency appendectomy as treatment for patients with uncomplicated AA confirmed by US and/or CT or MRI scan...
November 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28794797/acute-mesenteric-ischemia-guidelines-of-the-world-society-of-emergency-surgery
#19
REVIEW
Miklosh Bala, Jeffry Kashuk, Ernest E Moore, Yoram Kluger, Walter Biffl, Carlos Augusto Gomes, Offir Ben-Ishay, Chen Rubinstein, Zsolt J Balogh, Ian Civil, Federico Coccolini, Ari Leppaniemi, Andrew Peitzman, Luca Ansaloni, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Gustavo P Fraga, Fausto Catena
Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions. Therefore, although the entity is an uncommon cause of abdominal pain, diligence is always required because if untreated, mortality has consistently been reported in the range of 50%...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#20
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
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