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Surgical emergency department

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https://www.readbyqxmd.com/read/28104721/gastrointestinal-stromal-tumour-gist-presenting-as-a-strangulated-inguinal-hernia-with-small-bowel-obstruction
#1
Marco Massani, Giovanni Capovilla, Cesare Ruffolo, Nicolò Bassi
Gastrointestinal stromal tumours (GISTs) can arise everywhere along the gastrointestinal (GI) tract. Their presentation in unusual locations should always be taken into account. A 74-year-old man referred to the emergency department for small bowel obstruction caused by an incarcerated inguinal hernia. A CT scan showed a mesenchymal tumour originating from the herniated bowel loop and a mass in the ascending colon. Laparoscopic resection of the mass and laparoscopic right hemicolectomy were performed. The histology showed a ruptured GIST arising from the herniated small bowel and a high-grade dysplasia villous adenoma of the right colon...
January 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28103732/evaluation-of-antivenom-therapy-for-vipera-palaestinae-bites-in-children-experience-of-two-large-tertiary-care-pediatric-hospitals
#2
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/28099173/surgical-approach-for-ulcerated-locally-advanced-breast-cancer-a-single-center-experience-a-retrospective-study
#3
Rita Laforgia, Clelia Punzo, Annunziata Panebianco, Annalisa Volpi, Marina Minafra, Maria Grazia Sederino
AIM: The aim of our retrospective study is to analyze surgical possibilities for the extended LABC in those cases not suitable for a neoadjuvant chemotherapy step and to consider various reconstruction techniques. MATERIAL OF STUDY: Between 2009 and 2015 we enrolled 11 patients, admitted to the Emergency Department, presenting ulcerated LABC that needed palliative surgical demolitive procedures because of bleeding and anemia and in which was necessary to use natural tissues transposition or synthetic substitutes for the reconstruction of the skin flaps...
January 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28096279/a-framework-of-comfort-for-practice-an-integrative-review-identifying-the-multiple-influences-on-patients-experience-of-comfort-in-healthcare-settings
#4
REVIEW
Cynthia Wensley, Mari Botti, Ann McKillop, Alan F Merry
PURPOSE: Comfort is central to patient experience but the concept of comfort is poorly defined. This review aims to develop a framework representing patients' complex perspective of comfort to inform practice and guide initiatives to improve the quality of healthcare. DATA SOURCES: CINAHL, MEDLINE Complete, PsycINFO and Google Scholar (November 2016); reference lists of included publications. STUDY SELECTION: Qualitative and theoretical studies advancing knowledge about the concept of comfort in healthcare settings...
January 16, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28096229/disseminated-melioidosis-in-the-head-and-neck
#5
Tze Ling Loh, Sergios Latis, Graeme Crossland, Hemi Patel
A 35-year-old man was admitted to an intensive care unit with unilateral facial swelling and septic shock after multiple presentations to the emergency department with non-specific unilateral pain over the parotid area. A CT scan of his neck showed diffuse right-sided facial soft tissue infection, mastoid effusion and temporal lobe cerebritis. The upper lobes of his lungs had cannonball lesions that were suggestive of septic lung metastases. Blood cultures and ear canal swabs were positive for Burkholderia pseudomallei The temporal lobe cerebritis eventually developed into an abscess, necessitating a cortical mastoidectomy, craniectomy and temporal lobectomy...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28092120/pediatric-peritonsillar-abscess-outcomes-and-cost-savings-from-using-transcervical-ultrasound
#6
Zhen Huang, William Vintzileos, Heather Gordish-Dressman, Anjum Bandarkar, Brian K Reilly
OBJECTIVES: 1) To analyze clinical outcomes of children stratified by ultrasound into three diagnoses: acute tonsillitis, peritonsillar phlegmon, and abscess; and 2) To compare clinical outcomes and financial impact between children who underwent ultrasound protocol to those who did not. STUDY DESIGN: Retrospective analysis between two cohorts: ultrasound protocol group and control group. METHODS: Children with peritonsillar abscess (PTA) diagnosed in the emergency department (ED) were enrolled during a 2-year period for transcervical ultrasound evaluation of bilateral tonsillar fossae...
January 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28090817/coronary-or-ventricular-rupture-after-blunt-chest-trauma-a-clinical-dilemma
#7
Anton Sabashnikov, Guido Michels, Javid Fatullayev, Kaveh Eghbalzadeh, Mohamed Zeriouh, Stephan Baldus, Jens Wippermann, Thorsten Wahlers, Navid Madershahian
Cardiac rupture (CR) is one of the most serious and life-threatening complications of blunt chest trauma (BCT) usually associated with high mortality. Moreover, its diagnosis and treatment strategies may be extremely challenging for clinicians due to various anatomical localisations of the tear. Whereas most injuries fall under the category of right atrial ruptures, left ventricular lesions represent a rare type of this injury, with greater mortality, particularly in cases of multi-chamber injuries. However, not only cardiac chamber or great vessel ruptures may occur as a result of BCT; a growing number of reports also describe BCT-induced isolated coronary artery injuries, including ruptures...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28079306/open-dislocation-of-ankle-without-fracture-treated-with-an-external-fixator
#8
Emrah Sayit, Asli Tanrivermis Sayit, Elcin Zan
Ankle dislocations are orthopedic emergencies that require immediate treatment to avoid neurovascular impairment. They are usually accompanied by one or more comminuted fractures of the ankle mortis. In rare circumstances, such as high-energy trauma, the ankle dislocations may not be accompanied by concomitant malleolar fractures and, thus, are named "pure ankle dislocations". We presented a very rare and interesting case of an open medial dislocation of the ankle without associated fracture in an 18-year-old man with no known predisposing risk factors...
January 12, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28074727/-flank-pain-caused-by-a-renal-artery-dissection
#9
J C Karper, W M T Janssen, J C Breek, R Oosterhof-Berktas, J Gravendeel, T K Kremer Hovinga
BACKGROUND: A spontaneous renal artery dissection is a very rare diagnosis. The clinical presentation can vary and its course can be atypical. There are no guidelines available regarding treatment; however, the options are a conservative (medication) or interventional (radiological or surgical) approach. CASE DESCRIPTION: A 45-year-old man presented to the emergency department with hypertensive urgency after earlier episodes of flank pain. The cause appeared to be a spontaneous bilateral renal artery dissection with infarction...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28072666/outcomes-from-referrals-and-unscheduled-visits-from-community-emergency-departments-to-a-regional-pediatric-emergency-department-in-canada
#10
Ethan Reiner, Ardalan Ahmadi, Eric Grafstein, Quynh Doan
OBJECTIVES: Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care. METHODS: We conducted a retrospective cohort study reviewing all pediatric visits (age < 17 y) at 5 GEDs in Vancouver...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28069882/linea-arcuate-hernia-disguised-as-pfannenstiel-incision-s-hernia-a-case-report-and-a-systemic-literature-review
#11
Veronica Vincelli, Cesare Marazzi, Alberto Posabella, Aurore Steiger
We report a rare case of a 46-year-old woman 2 weeks after a cesarean section with Pfannenstiel incision, who presented at the Emergency Department with a significant abdominal pain accompanied by two episodes of vomiting. After that a clinical examination and an abdominal computed tomography scan were completed, a visceral herniation through Pfannenstiel incision was suspected. The indication of surgical exploration was clear. Finally, the laparotomy revealed a linea arcuata hernia with a hernia of the small intestine...
January 8, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28069418/splenic-artery-aneurysm-rupture-in-pregnancy
#12
Joshua Jacobson, Chad Gorbatkin, Stacey Good, Scott Sullivan
CASE PRESENTATION: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Subsequent CT obtained noted the rare but life-threatening diagnosis of ruptured splenic artery aneurysm that resulted in emergent transfer to the operating room with OB/GYN and general surgery...
December 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28068970/quadriplegia-caused-by-an-epidural-abscess-occurring-at-the-same-level-of-cervical-destructive-spondyloarthropathy-a-case-report
#13
Jun-Seok Lee, Ji-Hyun Ryu, Jong-Tae Park, Ki-Won Kim
BACKGROUND: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. CASE PRESENTATION: A 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level...
January 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28063812/left-main-occlusion-secondary-to-infective-endocarditis-vegetation-the-unusual-suspect
#14
Marco Pavani, Federico Conrotto, Fabrizio D'Ascenzo, Maurizio D'Amico, Paolo Centofanti, Fiorenzo Gaita
Treatment of acute coronary syndrome secondary to septic coronary embolism during valvular endocarditis is controversial. Urgent coronary angiography and stent implantation or surgical intervention have been proposed. We present the case of a patient presented at the emergency department with chest pain and cardiogenic shock. The coronary angiography showed a large filling defect in the left main due to a septic coronary embolism.
November 30, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28062176/characteristics-and-surgical-management-of-flap-compromise-caused-by-thrombosis-of-the-internal-jugular-vein
#15
Bin Yang, Yi Qu, Ming Su, Jinzhong Li, Hua Li, Rudong Xing, Zhengxue Han
BACKGROUND: A principal reason for flap compromise in oral and maxillofacial head and neck surgery, and failure of a free flap transfer, is thrombosis of a drainage vein such as the internal jugular vein. This study characterized flap compromise caused by internal jugular vein thrombosis after a free flap transfer, and its management. PATIENTS AND METHODS: A retrospective clinical study was conducted of 306 consecutive microvascular free flaps performed for 305 patients with head and neck cancer from March 2003 to March 2013 at the Department of Oral and Maxillofacial Surgery at Beijing Stomatological Hospital, Capital Medical University...
December 18, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28062078/-coexistence-of-acute-appendicitis-and-dengue-fever-a-case-report
#16
Juan Fidel Osuna-Ramos, Carlos Silva-Gracia, Gerardo Joel Maya-Vacio, Alejandra Romero-Utrilla, Efrén Rafael Ríos-Burgueño, Jesús Salvador Velarde-Félix
BACKGROUND: Dengue is the most important human viral disease transmitted by mosquitoes. It can be asymptomatic or it can present in any of its 3clinical forms: Dengue fever, dengue haemorrhagic fever and dengue shock syndrome. However, some atypical manifestations have been reported in surgical emergencies caused by acute appendicitis in patients with dengue fever. CLINICAL CASE: We report the case of an 18-year-old Mexican male who presented to the emergency department of the General Hospital of Culiacan, Sinaloa, with symptoms of dengue fever, accompanied by crampy abdominal pain with positive Rovsing and Dunphy signs...
January 3, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28059662/emergency-department-evaluation-and-30-day-readmission-after-craniotomy-for-primary-brain-tumor-resection-in-new-york-state
#17
Symeon Missios, Kimon Bekelis
OBJECTIVE Fragmentation of care has been recognized as a major contributor to 30-day readmissions after surgical procedures. The authors investigated the association of evaluation in the hospital where the original procedure was performed with the rate of 30-day readmissions for patients presenting to the emergency department (ED) after craniotomy for primary brain tumor resection. METHODS A cohort study was conducted, involving patients who were evaluated in the ED within 30 days after discharge following a craniotomy for primary brain tumor resection between 2009 and 2013, and who were registered in the Statewide Planning and Research Cooperative System (SPARCS) database of New York State...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28056991/severe-fracture-dislocation-of-the-thoracic-spine-without-any-neurological-deficit
#18
Shuai Zhang, Ting-Bin Yan
BACKGROUND: Fracture-dislocations of the thoracic spine without spinal cord injury are very rare. CASE PRESENTATION: A 35-year-old woman presented to our emergency department with complete T6-7 fracture-dislocation without any neurological loss had undergone a surgical reduction and fixation. CONCLUSIONS: The radiological severity of fracture-dislocation pattern doesn't correlate sometimes with the clinical manifestation.
January 5, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28056831/nasal-carriage-of-methicillin-resistant-staphylococcus-aureus-among-health-care-workers-at-al-shifa-hospital-in-gaza-strip
#19
Nabil Abdullah El Aila, Nahed Ali Al Laham, Basim Mohammad Ayesh
BACKGROUND: Nasal carriage of Staphylococcus aureus among hospital personnel is a common cause of hospital acquired infections. Emergence of drug resistant strains especially methicillin resistant S. aureus (MRSA) is a serious problem in hospital environment. Therefore, the aim of this study was to determine the nasal carriage rate of S. aureus and MRSA among Health Care Workers (HCWs) at Al Shifa Hospital, the major hospital in Gaza Strip. METHODS: A cross sectional study was conducted on 200 HCWs...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28053261/the-epidemiology-and-trends-in-management-of-acute-achilles-tendon-ruptures-in-ontario-canada-a-population-based-study-of-27-607-patients
#20
U Sheth, D Wasserstein, R Jenkinson, R Moineddin, H Kreder, S B Jaglal
AIMS: The aims of this study were to establish the incidence of acute Achilles tendon rupture (AATR) in a North American population, to select demographic subgroups and to examine trends in the management of this injury in the province of Ontario, Canada. PATIENTS AND METHODS: Patients ≥ 18 years of age who presented with an AATR to an emergency department in Ontario, Canada between 1 January 2003 and 31 December 2013 were identified using administrative databases...
January 2017: Bone & Joint Journal
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