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https://www.readbyqxmd.com/read/28429033/clinics-in-diagnostic-imaging-176-acute-embolic-occlusion-of-the-coeliac-artery
#1
Chinthaka Appuhamy, Justin Kwan, Martin Weng Chin H'ng, Sriram Narayanan, Sundeep Punamiya
A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28425094/fatal-acute-hemorrhagic-bowel-infarction-caused-by-mesenteric-venous-thrombosis
#2
Supawon Srettabunjong
Acute mesenteric venous thrombosis (MVT) is a rare, but life-threatening medical phenomenon. MVT is normally characterized by insidious onset, with nonspecific signs and symptoms. A high index of clinical suspicion is required for diagnosis, and emergency surgery is necessary to optimize the chances of patient survival, especially in the people aged more than 70 years. Surprisingly, based on my review of the literature, no fatal acute MVT case has been reported in the forensic literature. All reported such cases have been documented in medical literature, and most of them have been associated with underlying risk factors for venous thrombosis, such as hypercoagulable state, certain cancers, and stasis of the blood flow...
April 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28420518/acute-small-bowel-obstruction-caused-by-barbed-suture-on-the-second-day-after-laparoscopic-hysterosacropexy-a-case-report-and-literature-review
#3
Hsuan Chen, Mun-Kun Hong, Dah-Ching Ding
OBJECTIVE: To report a case of small bowel obstruction caused by barbed suture applied in hysterosacropexy, and possible solutions. CASE REPORT: A 57-year-old woman underwent laparoscopic hysterosacropexy for a Stage 2 uterine prolapse, presenting with acute abdominal pain and a bowel obstruction syndrome 2 days following the surgery. Conservative treatment was given, but the symptoms did not improve and gradually became worse. Diagnostic laparoscopy was performed on the 7(th) day after the hysterosacropexy, and the volvulus was found...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28419905/spontaneous-perforation-of-common-bile-duct-in-a-young-female-an-intra-operative-surprise
#4
Sudhir Kumar Mohanty, Tanmaya Mahapatra, Bharat Kumar Behera, Bidyapati Acharya, Supreet Kumar, Jyoti Ranjan Dash, Dibyasingh Meher, Malaya Ranjan Sarangi, Shiva Prasad Sahoo
INTRODUCTION: Spontaneous CBD perforation is one of the rare causes of acute abdomen in infants and extremely rare in adults. It is rarely suspected and correctly diagnosed preoperatively. PRESENTATION OF CASE: A 17year old female presented to Emergency Department with sudden onset of pain and distention of abdomen, associated with vomiting and non-passage of flatus and stool for 3days and features of generalized peritonitis. On exploration, a perforation of size 0...
April 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28409048/laparoscopic-reduction-and-closure-of-an-internal-hernia-secondary-to-gynecologic-surgery
#5
Takashi Sakamoto, Alan Kawarai Lefor
Internal hernia is a rare cause of bowel obstruction which often requires emergent surgery. In general, the preoperative diagnosis of internal hernia is difficult. The pelvic cavity has various spaces with the potential to result in a hernia, especially in females. In this report, we describe a patient with an internal hernia secondary to previous gynecologic surgery. A 49-year-old woman presented with acute abdominal pain and a history of previous right oophorectomy for a benign ovarian cyst. Computed tomography scan of the abdomen showed obstruction with strangulation and emergent laparoscopic exploration was performed...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28404008/surgery-versus-conservative-management-for-recurrent-and-ongoing-left-sided-diverticulitis-direct-trial-an-open-label-multicentre-randomised-controlled-trial
#6
Bryan J M van de Wall, Marguerite A W Stam, Werner A Draaisma, R Stellato, Willem A Bemelman, Marja A Boermeester, Ivo A M J Broeders, Eric J Belgers, Boudewijn R Toorenvliet, Hubert A Prins, Esther C J Consten
BACKGROUND: Patients with recurrent or persisting complaints after an episode of left-sided diverticulitis are managed with either conservative measures or elective sigmoidectomy. To date, there are no data from randomised trials. We aimed to establish which treatment leads to a better quality of life for patients with diverticulitis. METHODS: We did an open-label, multicentre, randomised controlled trial (DIRECT trial) in 24 teaching and two academic hospitals in the Netherlands...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403121/pheochromocytoma-crisis-in-icu-a-french-multicenter-cohort-study-with-emphasis-on-rescue-extracorporeal-membrane-oxygenation
#7
Bertrand Sauneuf, Nicolas Chudeau, Benoit Champigneulle, Claire Bouffard, Marion Antona, Nicolas Pichon, David Marrache, Romain Sonneville, Antoine Marchalot, Camille Welsch, Antoine Kimmoun, Bruno Bouchet, Elmi Messai, Sylvie Ricome, David Grimaldi, Jonathan Chelly, Jean-Luc Hanouz, Alain Mercat, Nicolas Terzi
OBJECTIVES: To describe the characteristics, management, and outcome of patients admitted to ICUs for pheochromocytoma crisis. DESIGN: A 16-year multicenter retrospective study. SETTING: Fifteen university and nonuniversity ICUs in France. PATIENTS: Patients admitted in ICU for pheochromocytoma crisis. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: We included 34 patients with a median age of 46 years (40-54 yr); 65% were males...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403081/evaluation-of-extrapancreatic-inflammation-on-abdominal-computed-tomography-as-an-early-predictor-of-organ-failure-in-acute-pancreatitis-as-defined-by-the-revised-atlanta-classification
#8
Chenyang Chen, Zixing Huang, Hang Li, Bin Song, Fang Yuan
The aim of the study was to determine whether extrapancreatic inflammation on computed tomography (EPIC) is helpful in predicting organ failure in the early phase of acute pancreatitis (AP) as defined by the 2012 revised Atlanta classification.Patients (n = 208) who underwent abdominal computed tomography (CT) within 24 hours after AP onset and admission were retrospectively identified. Each patient's EPIC score, Balthazar score, bedside index of severity in acute pancreatitis (BISAP), and systemic inflammatory response syndrome (SIRS) score were obtained...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28399884/mammary-gland-tumors-in-a-male-cocker-spaniel
#9
Soon-Chan Kwon, Dae-Young Yoo, Minho Ko, Kwon-Young Lee, Ho-Hyun Kwak, In-Chul Park, In-Koo Hwang, Jung-Hoon Choi, Jin-Young Chung
BACKGROUND: Mammary gland tumors are the most common tumors in sexually intact female dogs; however, they are rare in male dogs. This study was conducted to investigate the relationship between sexual hormones and mammary gland tumors in a male dog. CASE PRESENTATION: A 13-year-old, intact male Cocker Spaniel presented to the Veterinary Teaching Hospital of Kangwon National University, Republic of Korea, with an acute right ruptured caudal abdominal mass. Physical examination revealed a 14 × 14 cm ruptured mass in the right caudal abdomen, as well as a 1...
April 11, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28395448/-clinical-features-diagnosis-treatment-and-prognosis-of-99-cases-with-primary-intestinal-lymphoma
#10
L Y Ping, Y Q Song, W Zheng, X P Wang, Y Xie, N J Lin, M F Tu, Z T Ying, W P Liu, C Zhang, L J Deng, J Zhu
Objective: To investigate the clinical features, diagnosis, treatment and prognosis of primary intestinal lymphoma (PIL) . Methods: The characteristics, diagnosis, treatment methods, and follow-up outcomes of 99 PIL patients, diagnosed in Peking university cancer hospital between Nov.1,1995 and Nov. 30, 2013. Results: There were 65 males and 34 females with a median age of 50 years. The majority of clinical manifestation were non-specific gastrointestinal symptoms, 67.68% of cases presented abdominal pain, 26...
March 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#11
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28386273/acute-colonic-pseudo-obstruction-with-feeding-intolerance-in-critically-ill-patients-a-study-according-to-gut-wall-analysis
#12
Chenyan Zhao, Tingbin Xie, Jun Li, Minhua Cheng, Jialiang Shi, Tao Gao, Fengchan Xi, Juanhong Shen, Chun Cao, Wenkui Yu
Objective. To compare the differences between acute colonic pseudo-obstruction (ACPO) with and without acute gut wall thickening. Methods. ACPO patients with feeding tolerance were divided into ACPO with no obvious gut wall thickening (ACPO-NT) group and ACPO with obvious acute gut wall thickening (ACPO-T) group according to computed tomography and abdominal radiographs. Patients' condition, responses to supportive measures, pharmacologic therapy, endoscopic decompression, and surgeries and outcomes were compared...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28383226/-patient-volume-and-quality-in-surgery-for-abdominal-aortic-aneurysm
#13
Astrid Austvoll-Dahlgren, Vigdis Underland, Gyri Hval Straumann, Louise Forsetlund
BACKGROUND Patient volume is assumed to affect quality, whereby complex procedures are best performed by those who perform them frequently. We have conducted a systematic review of the research on the association between patient volume and quality of vascular surgery. In this article we describe the outcomes for abdominal aortic aneurysm surgery.MATERIAL AND METHOD We undertook systematic searches in relevant databases. We searched for systematic reviews, and randomised and observational studies. The search was concluded in December 2015...
April 2017: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/28372456/paraesophageal-hernia-and-gastric-volvulus-an-uncommon-etiology-of-vomiting-and-upper-gastrointestinal-bleeding
#14
Gonçalo Nunes, Marta Patita, Vítor Fernandes, Jorge Fonseca
The authors report the case of a 75 year-old woman admitted to the emergency room with abdominal pain and coffee ground vomiting. Marked epigastric distension with tenderness and signs of severe dehydration were present. Upper GI endoscopy showed a black esophagus covered by a large amount of dark fluid, diffuse hyperaemia and superficial erosions. Marked distortion of gastric anatomy caused by stomach rotation and a large paraesophageal hernia was observed and the pylorus was not identified. Chest X-ray and CT scan confirmed the presence of an organoaxial gastric volvulus with antero superior rotation and incarceration of the gastric antrum, which was located above the diaphragm...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28365715/gall-bladder-agenesis-a-rare-embryonic-cause-of-recurrent-biliary-colic
#15
Aarthi Rajkumar, Albina Piya
BACKGROUND Gallbladder agenesis (GA) is an extremely rare anatomic anomaly with a reported incidence of less than 0.5%. It is usually asymptomatic, but can present with features of biliary colic and cholecystitis. We present here a case of GA in a patient with recurrent biliary colic.  CASE REPORT A 24-year-old African American woman presented with recurrent episodes of right upper-quadrant abdominal pain. During her first episode, she was found to have elevated transaminases and clinical features of cholecystitis, but ultrasound did not visualize a gallbladder and she was discharged with a diagnosis of biliary colic...
April 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28363097/gastrointestinal-emergencies-in-critically-ill-cancer-patients
#16
Delphine Lebon, Lucie Biard, Sophie Buyse, David Schnell, Etienne Lengliné, Camille Roussel, Jean-Marc Gornet, Nicolas Munoz-Bongrand, Laurent Quéro, Matthieu Resche-Rigon, Elie Azoulay, Emmanuel Canet
PURPOSE: To describe gastrointestinal emergencies in cancer patients. METHODS: All cancer patients admitted to the medical ICU of Saint-Louis Hospital for an acute abdominal syndrome during the study period (1997-2011) were included. RESULTS: A total of 164 patients were included. The most common diagnoses were: neutropenic enterocolitis (NE) (n=54, 33%), infectious colitis and peritonitis (n=51, 31%), bowel infiltration by malignancy (n=14, 9%), and mucosal toxicity of chemotherapy (n=12, 7%)...
March 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28362714/iloprost-prostaglandin-e1-and-papaverine-relax-human-mesenteric-arteries-with-similar-potency
#17
Christoph Mahlke, Jens-Peter Kühn, Birger Mensel, André Schreiber, Annett Juretzko, Antje Steinbach, Olaf Grisk
OBJECTIVE: Non-occlusive mesenteric ischemia (NOMI) is accompanied by mesenteric artery spasms that are at least in part due to endothelin system activation. Acute treatment includes intra-arterial infusion of vasodilators such as iloprost, prostaglandin E1 (PGE1) and papaverine. Their effectiveness is not well characterized in human mesenteric arteries. We directly compared their potency to relax isolated human mesenteric arteries. To explore the potential of Rock inhibition to treat mesenteric artery spasms, we tested if endothelin-1 (ET-1)-induced mesenteric artery constrictions depend rho kinase (Rock)...
March 30, 2017: Shock
https://www.readbyqxmd.com/read/28362192/ovarian-metastasis-from-lung-adenocarcinoma-with-alk-positive-rearrangement-detected-by-next-generation-sequencing-a-case-report-and-literatures-review
#18
Xuquan Jing, Feng Li, Xue Meng, Zhitong Liu, Jinming Yu, Bo Liu
Ovarian metastasis is an exceptionally rare condition in lung adenocarcinoma patients and is often difficult to distinguish from primary ovarian carcinoma. ALK (anaplastic lymphoma kinase) tyrosine kinase inhibitors elicit a significant objective response rate and are well-tolerated in advanced ALK-positive lung cancer. Hence, we report a case of a 41-year-old woman with ovarian metastases from NSCLC. After receiving a 6 course first line chemotherapy and 8 course maintenance therapy, the patient suffered acute abdominal pain, so surgery was performed...
March 31, 2017: Cancer Biology & Therapy
https://www.readbyqxmd.com/read/28359795/estimation-of-v-possum-and-e-pass-scores-in-prediction-of-acute-kidney-injury-in-patients-after-elective-open-abdominal-aortic-aneurysm-surgery
#19
Andrzej Siemiatkowski, Agnieszka Jablonowska, Joanna Pietrewicz, Jerzy Glowinski
BACKGROUND: V-POSSUM and E-PASS scoring systems are usually used to predict morbidity and early mortality in surgical patients. We conducted this study to assess the validity of the V-POSSUM and E-PASS scores in predicting risk of acute kidney injury (AKI) development in patients undergoing elective open abdominal aortic aneurysm (AAA) repair. METHODS: We studied a consecutive series of 171 patients with AAA, qualified for elective open infrarenal repair. Patients underwent a thorough examination and the physiological and surgical stress components of the V-POSSUM and E-PASS scores were calculated...
March 27, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#20
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
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