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https://www.readbyqxmd.com/read/29455390/utility-of-multiple-rule-out-ct-screening-of-high-risk-atraumatic-patients-in-an-emergency-department-a-feasibility-study
#1
Mia M Pries-Heje, Rasmus B Hasselbalch, Henriette Raaschou, Bijan Rezanavaz-Gheshlagh, Hanne Heebøll, Shazia Rehman, Mariana Kristensen, Erik Henning Andersen, Lisbet Ravn, Michel C Nèmery, Morten N Lind, Thomas Boel, Peter Sommer Ulriksen, Kasper K Iversen
BACKGROUND: Several large trials have evaluated the effect of CT screening based on specific symptoms, with varying outcomes. Screening of patients with CT based on their prognosis alone has not been examined before. For moderate-to-high risk patients presenting in the emergency department (ED), the potential gain from a CT scan might outweigh the risk of radiation exposure. We hypothesized that an accelerated "multiple rule out" CT screening of moderate-to-high risk patients will detect many clinically unrecognized diagnoses that affect change in treatment...
February 17, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29455011/hybrid-retrograde-celiac-artery-stenting-for-acute-mesenteric-ischemia-after-gastric-surgery
#2
Duarte Rego, Paulo Almeida, Paulo Soares, Rui Almeida
INTRODUCTION: Celiac artery (CA) occlusions/stenosis are infrequently associated with liver ischemia due to its unique vascularization where portal vein provides about 75% of liver's perfusion. Collateral flow from gastroduodenal artery also provides, in most cases, enough blood supply to prevent ischemic hepatitis. In cases where these collateral pathways are compromised severe liver ischemia can occur. METHODS: We present a case of acute mesenteric ischemia following gastric surgery that was treated with a hybrid retrograde CA stenting...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29447407/the-feasibility-of-venovenous-ecmo-at-role-2-facilities-in-austere-military-environments
#3
Mohamed A T Mohamed, Tareq Maraqa, Matthew D Bacchetta, Michael McShane, Kenneth L Wilson
Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been gaining use to bridge the recovery from acute respiratory distress syndrome (ARDS) refractory to conventional treatment. However, these interventions are often limited to higher echelons of military care. We present a case of lung salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) facility in an austere military environment in Afghanistan. Case: A 25-year-old Afghani soldier presented to an R2 facility with blast lung injury and multiple penetrating injuries following an explosion...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29435218/giant-colonic-diverticulum-a-rare-cause-of-acute-abdomen
#4
Athanasios Syllaios, Dimitra Daskalopoulou, Nikolaos Bourganos, Anastasia Papakonstantinou, Evangelia Triantafyllou, Antonios Koutras, Christos Georgiou
Giant colonic diverticulum (GCD), defined as diverticulum larger than 4 cm, is a rare entity. It is generally a manifestation of colonic diverticular disease and can have dramatic complications such as perforation, abscess, volvulus, infarction and adenocarcinoma. This report documents the case of a 63-year-old man coming to the Emergency Department with acute abdomen due to a perforation of a GCD. In the plain abdominal X-ray the 'Balloon-sign' was revealed, computed tomography scan and Hartmann's procedure were performed...
February 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29434169/different-patterns-in-abdominal-stab-wound-in-the-self-inflicted-and-assaulted-patients-an-observational-analysis-of-single-center-experience
#5
Takeshi Nishimura, Hiroyuki Sakata, Taihei Yamada, Mariko Terashima, Kunihiro Shirai, Isamu Yamada, Joji Kotani
Patterns of penetrating abdominal stab wounds (ASW) may be different according to the mechanism of injury. The purpose of this study was to review and characterize penetrating abdominal stab wounds in self-inflicted wound patients and assaulted patients. We retrospectively analyzed patients with ASW who were admitted to our emergency department from 2007 to 2015. The patients were divided into two groups: self-inflicted wound group and assaulted group. There were 46 stabbing cases in 45 different patients (25 males, 21 females; average age 47 y, range 21 to 85 y)...
July 20, 2017: Kobe Journal of Medical Sciences
https://www.readbyqxmd.com/read/29423152/suppurative-appendicitis-presenting-acute-scrotal-pain-a-rare-condition-may-confuse-surgeons
#6
Shahriar Najafizadeh-Sari, Hamidreza Mehdizadeh, Mohammad Sadegh Bagheri-Baghdasht, Shahram Manoochehry
Scrotal pain presentation has many differential diagnoses such as testicular torsion is surgical emergency. For this reason, it is necessary for surgeons to differentiate between diseases for choosing the best treatment approach. We have reported a rare condition of 19-year-old male case had an atypical scrotal pain presentation of appendicitis. He was admitted to emergency service with 4 days history of pain in abdomen and testis. In physical examination, there is tenderness in right lower quadrant, right inguinal region and scrotum...
October 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29422033/a-case-report-of-tubo-ovarian-abscess-caused-by-burkholderia-pseudomallei
#7
Pattaranit Nernsai, Areepan Sophonsritsuk, Srithean Lertvikool, Artit Jinawath, Maria Nina Chitasombat
BACKGROUND: Melioidosis, the disease caused by Burkholderia pseudomallei is endemic in the Northeastern part of Thailand, South-East Asia, and Northern Australia. The pelvic involvement of disease is rare even in an endemic area. Therefore, we describe in this report the clinical presentation, management, and outcome of the patient with primary tubo-ovarian abscess due to melioidosis. CASE PRESENTATION: A 31-year-old Thai cassava farmer woman presented with fever and abdominal pain at left lower quadrant for one month...
February 8, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29420397/exercise-induced-abdominal-wall-muscle-injury-resulting-in-rhabdomyolysis-and-mimicking-an-acute-abdomen
#8
Charlene G Echague, John M Csokmay
BACKGROUND: Rhabdomyolysis is characterized by muscle necrosis and release of intracellular constituents, causing muscle pain, weakness, and myoglobinuria. This can be attributed to muscle injury after strenuous exercise. If the abdominal wall is involved, clinical presentation may resemble an acute abdomen. CASE: A 27-year-old woman, gravida 4 para 2, presented with swelling and pain of the mons pubis and abdominal pain after intense powerlifting 2 days prior. A computed tomography scan was performed, revealing abdominal wall inflammation...
February 5, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29417386/vimentin-positive-gastric-adenocarcinoma-arising-in-a-hyperplastic-polyp
#9
Shogo Kawaguchi, Tetsuro Yoshimura, Hirotake Sakuraba, Taka Asari, Yohei Sawada, Yasumitsu Araki, Koji Kikuchi, Toyohito Wada, Tomomi Kusumi, Shinsaku Fukuda
We report a case of vimentin-positive early gastric adenocarcinoma arising in a hyperplastic polyp (HP). A 72-year-old Japanese man was admitted for the detailed examination of a gastric polyp. He had a subtotal gastrectomy due to acute abdomen 12 years ago. Upper endoscopy revealed a pedunculated polyp measuring approximately 2 cm on the greater curvature of upper body of the remnant stomach. Magnifying endoscopy revealed that the microsurface pattern was irregular and partially absent accompanied with irregular microvessels at the upper end of the polyp...
February 7, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29417038/miliary-tuberculosis-with-pulmonary-and-extrapulmonary-component-complicated-with-acute-respiratory-distress-syndrome
#10
Bhupen Barman, Iadarilang Tiewsoh, Kyrshanlang G Lynrah, Baphira Wankhar, Taso Beyong, Neel Kanth Issar
Miliary tuberculosis results from the lymphohematogenous spread of the tubercle bacilli to the vascular beds in the lungs and other organs. Diagnosis is made by clinical judgment and chest X-ray showing miliary mottling of the lung fields. Another imaging study like computed tomography imaging of the lungs and abdomen can also be supportive in diagnosing miliary tuberculosis. We present a case of miliary tuberculosis in an immunocompetent young male with atypical manifestation of a left-sided pleural effusion and a life-threatening complication of acute respiratory distress syndrome during hospital stay which required noninvasive mechanical ventilation and steroids therapy, along with antitubercular medication...
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29413758/therapeutic-effect-of-%C3%AE-emitting-224ra-labeled-calcium-carbonate-microparticles-in-mice-with-intraperitoneal-ovarian-cancer
#11
Sara Westrøm, Tina B Bønsdorff, Øyvind S Bruland, Roy H Larsen
BACKGROUND: Ovarian cancer patients with chemotherapy-resistant residual microscopic disease in the peritoneal cavity have a considerable need for new treatment options. Alpha-emitting radionuclides injected intraperitoneally may be an attractive therapeutic option in this situation as they are highly cytotoxic, while their short range in tissues can spare surrounding radiosensitive organs in the abdomen. Herein we evaluate the therapeutic efficacy of a novel α-emitting compound specifically designed for intracavitary radiation therapy...
January 27, 2018: Translational Oncology
https://www.readbyqxmd.com/read/29412233/thoracotomy-compared-to-laparotomy-in-the-traumatic-diaphragmatic-hernia-systematic-review-and-proportional-methanalysis
#12
Gracilene Pinheiro Silva, Daniele Cristina Cataneo, Antonio Jose Maria Cataneo
PURPOSE: To evaluate the most used approach to treat traumatic diaphragmatic ruptures, and in which one the requirement to assess the second cavity is more frequent. METHODS: Systematic review, observational studies. Outcomes: moment of approach, most commonly via addressed and the requirement to open the other cavity. Bases searched: Lilacs, Pubmed, Embase, Clinicaltrials.gov and Web of Science. Statistical analysis: StatsDirect 3.0.121 software. RESULTS: Sixty eight studies (2023 participants) were included...
January 2018: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29409663/penta-therapy-for-severe-acute-hyperlipidemic-pancreatitis-a-retrospective-chart-review-over-a-10-year-period
#13
Jian Lu, Yun Xie, Jiang Du, Mei Kang, Wei Jin, Yan Li, Hui Xie, Ruijie Cheng, Rui Tian, Ruilan Wang
INTRODUCTION: The purpose of our study is to evaluate the efficacy of penta-therapy for HL-SAP in a retrospective study. METHODS: Retrospective study between January 2007 and December 2016 in a hospital intensive care unit. HL-SAP patients were assigned to conventional treatment alone (the control group) or conventional treatment with the experimental protocol (the penta-therapy group) consists of blood purification, antihyperlipidemic agents, low-molecular weight heparin, insulin, covering the whole abdomen with Pixiao (a traditional Chinese medicine)...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29409072/the-acutely-limping-preschool-and-school-age-child-an-imaging-perspective
#14
Apeksha Chaturvedi, Usa Cain, Andrey Rupasov
Acute limp in a child presents a diagnostic conundrum and can result from a variety of causes. The underlying etiology is often referable to the hip, but the spine, abdomen, pelvis, or knee can be alternatively implicated. An adequate clinical history and satisfactory physical examination are often difficult in younger children. Consequently, there is disproportionate reliance on imaging to arrive at the correct diagnosis. The potential for rapid clinical deterioration and long-term sequelae is a risk with some of the conditions presenting with acute hip (septic hip, osteomyelitis)...
February 2018: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/29406296/abdominal-catastrophe-in-crohn-s-disease-surgery
#15
Hugo Palma Rios, André Goulart, Pedro Leão
INTRODUCTION: Performing surgery on patients with Crohn's disease is a true challenge due to the elevated risk of complications related to the chronic proinflammatory response. Stenosis is the leading cause of intestinal resection in these patients. CASE REPORT: The authors present the case of a 50-year-old woman with inflammatory stenosis of the terminal ileum due to Crohn's disease. The patient underwent a laparoscopic ileocecal resection, which was complicated by a small anastomotic dehiscence with localized peritonitis...
January 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29404804/variation-in-emergency-department-use-of-computed-tomography-for-investigation-of-acute-aortic-dissection
#16
Robert Ohle, Omar Anjum, Helena Bleeker, George Wells, Jeffrey J Perry
INTRODUCTION: Acute aortic dissection (AAD) is a life-threatening condition making early diagnosis critical. Although 90% present with acute pain, the myriad of associated symptoms can make diagnosis a challenge. Our objective was to assess how we are using computed tomography to rule out acute aortic dissection specifically rate of ordering, diagnostic yield, and variation in practice. METHODS: We included consecutive adult patients presenting to two tertiary academic care emergency departments over one calendar year presenting with non-traumatic chest, back, abdominal, or flank pain...
February 5, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29404160/spontaneous-splenic-rupture-in-the-early-postoperative-period-to-after-lobectomy
#17
Ayşe Gül Ergönül, Tevfik İlker Akçam, Ali Özdil, Ufuk Çağırıcı
Spontaneous splenic rupture is a quite rare entity that may develop secondary to some special situations (lymphoma, post-abdominal surgey etc). In the literature, the case of a patient has been reported following thoracic surgery. In a patient who had undergone right upper lobectomy for pulmonary carcinoma, signs of acute abdomen and low levels in the hemogram were detected on the fifth postoperative day; therefore, the patient underwent further investigations. A radiological evaluation revealed splenic rupture, and the patient was operated on...
April 2017: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29403216/enterobius-vermicularis-infestation-leading-to-meckel-s-diverticulitis-in-an-adolescent-boy-an-extremely-rare-presentation
#18
Manupriya Sharma, Rashmi Kaul, Bal Chander
Enterobius vermicularis is an intestinal nematode commonly affecting children worldwide. Its transmission is by feco-oral route. Meckel's diverticulitis due to E. vermicularis infestation is an extremely rare presentation. An 11-year-old boy presented with acute abdomen. During surgery inflamed Meckel's diverticulum (M.D) was seen. Histopathology examination of specimen revealed E. vermicularis. Till date, only one case of E. vermicularis infestation of M.D is reported around five decades ago. This histopathological confirmation is extremely important as the required treatment (Mebendazole) of the infected case along with household contacts can prevent the spread of infection and may avoid surgery in known contacts...
January 2018: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/29397887/ten-year-trends-in-traumatic-injury-mechanisms-and-outcomes-a-trauma-registry-analysis
#19
REVIEW
Zhamak Khorgami, William J Fleischer, Yuen-Jing A Chen, Nasir Mushtaq, Michael S Charles, C Anthony Howard
BACKGROUND: The Oklahoma Trauma Registry (OTR) collects data from all state-licensed acute care hospitals. This study investigates trends and outcomes of trauma in Oklahoma using OTR. METHODS: 107,549 patients (2005-2014) with major severity and one of the following criteria were included: length of hospital stay ≥48 h, dead on arrival or death in the hospital, hospital transfer, ICU admission, or surgery on the head, chest, abdomen, or vascular system. Patient characteristics, mechanisms of injury, and outcomes of trauma were analyzed...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29394572/-a-case-of-perforative-peritonitis-due-to-intestinal-metastasis-from-lung-cancer
#20
Chizu Yamada, Hiroshi Nitta, Fumihiko Ishikawa, Yoshihisa Fujita, Hideyuki Omoto, Shigeyuki Kamata, Youhei Miyauchi, Takashi Morinaka, Hiroshi Ito
We here describe a case of an acute peritonitis due to perforation of a small intestine tumor metastasized from a lung cancer. A 66-year-old man who had undergone a bladder cancer procedure 2 years ago and was hospitalized for the second operation, complained sudden abdominal pain. An enhanced abdominal CTrevealed a small amount of free gas and ascites in the abdominal cavity. On the same day, emergency exploratory surgery was performed with the diagnosis of perforative peritonitis. A laparotomy revealed a jejunal tumor with perforation 40 cm distal from the Treitz ligament...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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