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https://www.readbyqxmd.com/read/28534559/-gastric-volvulus-an-infrequent-cause-of-acute-abdominal-pain
#1
D Ruiz-Clavijo García, A Zuñiga Ripa, L Casanova Ortíz, I García de Eulate Martín-Moro, B González de la Higuera Carnicer, J Urman Fernández
Gastric volvulus (GV) is characterized by the abnormal rotation of a portion of the stomach around a horizontal or vertical axis that can cause obstruction, vascular disorder and even strangulation, and may evolve into necrosis or even perforation. It can be classified according to its aetiology into primary or secondary GV, according to its anatomy into axial organ or into axial mesenteric GV, and according to its presentation into chronic or acute GV. Both types of volvulus require treatment; however, in spite of the classic treatment being open surgery, there is no standard treatment, nor is there consensus on the alternative of choice at present...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28531869/a-rare-case-of-subacute-appendicitis-actinomycosis-as-the-final-pathology-reports-a-case-report-and-literature-review
#2
G A Gómez-Torres, O S Ortega-Gárcia, E G Gutierrez-López, C A Carballido-Murguía, J A Flores-Rios, C R López-Lizarraga, C A Bautista López, C F Ploneda-Valencia
INTRODUCTION: Acute appendicitis is the most common indication for an emergency abdominal surgery in the world, with a lifetime incidence of around 10%. Actinomycetes are the etiology of appendicitis in only 0.02%-0.06%, having as the final pathology report a chronic inflammatory response; less than 10% of the cases are diagnosed before surgery. Here, we present the case of a subacute appendicitis secondary to actinomycosis. CASE REPORT: A 39-year-old male presented with a twelve-day evolution of intermittent abdominal pain in the right lower quadrant, treated at the beginning with ciprofloxacin and urinary analgesic...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28529168/opioids-in-gastroenterology-treating-adverse-effects-and-creating-therapeutic-benefits
#3
Michael Camilleri, Anthony Lembo, David A Katzka
The use of opioid medications on both an acute and chronic basis is ubiquitous in the U.S. As opioid receptors densely populate the gastrointestinal tract, symptoms and side effects can be expected in these patients. In the esophagus, dysmotility may result manifesting with dysphagia and a syndrome indistinguishable from primary achalasia. In the stomach, a marked delay in gastric emptying may ensue with postprandial nausea and early satiety. Postoperatively, particularly with abdominal surgery, opioid induced ileus may ensue...
May 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28527248/-clinical-and-demographic-profile-and-risk-factors-for-clostridium-difficile-infection
#4
Carlos Carvajal, Carlos Pacheco, Fabián Jaimes
INTRODUCTION: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. OBJECTIVE: To determine the clinical characteristics of hospitalized patients with C. difficile infection. MATERIALS AND METHODS: We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#5
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28525410/sm22-a-plasma-biomarker-for-human-transmural-intestinal-ischemia
#6
Dirk H S M Schellekens, Kostan W Reisinger, Kaatje Lenaerts, M'hamed Hadfoune, Steven W Olde Damink, Wim A Buurman, Cornelis H C Dejong, Joep P M Derikx
OBJECTIVE: To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia. BACKGROUND: Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperative because it mandates emergency surgery. Since early clinical and radiological signs are nonspecific, there is an urgent need for accurate biomarkers...
May 18, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28522915/ninety-day-readmissions-after-inpatient-cholecystectomy-a-5-year-analysis
#7
Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Farah Al-Shwely, Roberto De la Plaza-Llamas, José Manuel Ramia
AIM: To determine the incidence of readmission after cholecystectomy using 90 d as a time limit. METHODS: We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#8
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28511550/ct-features-in-surgically-proven-cases-of-ovarian-torsion-a-pictorial-review
#9
Sunita Dhanda, Swee Tian Quek, Ying Ting Mok, Clement Yong Hsiang Rong, Yuik Sing Eric Ting, Pooja Jagmohan, Bernard Wee
Ovarian torsion is a surgical emergency characterized by a partial or complete rotation of the ovarian vascular pedicle, causing obstruction to venous outflow followed by arterial inflow. Clinically, ovarian torsion frequently mimics other causes of acute pelvic pain such as appendicitis, diverticulitis, renal colic etc. Ultrasonography (US) is the first line imaging modality of choice for evaluation of ovarian torsion. MRI is useful as a problem solving tool in patients with equivocal or non diagnostic US studies...
May 16, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28504118/direct-evidence-of-central-nervous-system-axonal-damage-in-patients-with-postoperative-delirium-a-preliminary-study-of-pnf-h-as-a-promising-serum-biomarker
#10
Reo Inoue, Masahiko Sumitani, Toru Ogata, Hirotaka Chikuda, Takehiro Matsubara, So Kato, Nobutake Shimojo, Kanji Uchida, Yoshitsugu Yamada
INTRODUCTION: Approximately 50%-80% patients experience postoperative delirium, an acute cognitive dysfunction associated with prolonged hospitalization, increased mortality, excess healthcare costs, and persistent cognitive impairment. Elucidation of the mechanism of delirium and associated diagnostic and therapeutic measures are urgently required. Here we investigated the role of phosphorylated neurofilament heavy subunit (pNF-H), a major structural protein in axons, as a predictive maker of postoperative delirium...
May 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28501824/the-vanishing-duodenal-polyp-mesenteric-invagination-presenting-as-duodenal-pseudopolyp
#11
Bernadette S de Bakker, Saffire S K S Phoa, Mohammed Kara, Sabaa Al-Eryani, Marieke E Gielen, Cyriel I J Ponsioen, Henri M de Bakker, Thomas M van Gulik
Duodenal polypoid masses are an uncommon finding mainly diagnosed incidentally at endoscopy or surgery. We report a 39-year-old female patient with symptoms of intermittent stabbing pain in the upper right abdominal quadrant and an iron deficiency anaemia, without complaints of weight loss, haematemesis or melaena. A duodenal polyp and acute duodenitis have been described during endoscopic examinations and CT and ultrasound. Surgical excision of the polyp was advised. Intraoperatively, an elongated duodenum was remarkable; however, at duodenotomy, no polyp was found, nor during intraoperative endoscopy...
May 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28492221/accuracy-of-modified-alvarado-score-eskelinen-score-and-ohmann-score-in-diagnosing-acute-appendicitis
#12
Pejana Rastović, Zoran Trninić, Gordan Galić, Zdrinko Brekalo, Josip Lesko, Marko Pavlović
INTRODUCTION: By processing the data of a large number of patients with abdominal pain, diagnostic scores whose implementation attempts to facilitate acute appendicitis diagnostics were developed. Modified Alvarado score, Ohmann score and Eskelinen score are used as assistance when setting the diagnosis and making a decision to undertake surgery. AIM: To assess accuracy of Alvarado score, Ohmann score and Eskelinen score in diagnosing acute appendicitis and to establish connection of total score of these scoring systems with histopathological degree of appendicitis...
May 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28491882/portal-vein-thrombosis-in-the-setting-of-newly-diagnosed-cushing-s-syndrome
#13
Alexandria D McDow, Anju Gurung, Rama Poola, Carmel Fratianni, Marc Garfinkel, Michael G Jakoby
The hallmark manifestations of Cushing's syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Factor VIII activity was approximately 2.5-fold elevated, a known mechanism by which hypercortisolemia predisposes to venous thrombosis...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28491458/caecocolic-intussusception-associated-with-a-caecal-polyp-and-concurrent-hepatocellular-carcinoma-in-a-cat
#14
Lara Boland, Scott Lindsay, Laurencie Brunel, Juan Podadera, Peter Bennett
CASE SUMMARY: A 17-year-old female neutered domestic shorthair cat presented for several days of reduced faecal volume and a rectal prolapse. Physical examination revealed a 2 cm rectal prolapse, hepatomegaly and a low body condition score of 3/9. Haematology and biochemistry revealed a mild non-regenerative anaemia (haematocrit 24.5%; reference interval [RI] 30.3-52.3%), a mild mature neutrophilia (16.21 × 10(9)/l; RI 1.48-10.29 × 10(9)/l) and a mild increase in alanine aminotransferase activity (222 IU/l; RI 12-130 IU/l)...
January 2017: JFMS Open Rep
https://www.readbyqxmd.com/read/28491176/nontraumatic-urinary-bladder-rupture-presenting-as-renal-pseudo-failure-and-ascites
#15
Andrew Mark, Moshe Meister, Benjamin Opara, Robert Chow
A 24-year-old man, with past medical history significant only for nocturnal enuresis until the age of 12 years, presented to the emergency department with acute abdominal pain after an episode of difficulty with micturition in the middle of the night. On presentation, physical examination was suggestive of ascites and laboratories revealed an elevated serum creatinine of 1.88 mg/dL. He was subsequently found to have a ruptured bladder, without any inciting trauma, which required surgical repair. His only surgical history is an unknown, apparently urologic, surgery when he was 11-12 years old...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28480725/omental-torsion-an-infrequent-cause-of-abdominal-pain
#16
José Ramón Torres Alfonso, Delia Cortés Guiral, Javier Jesús Barambio Buendía, Damián García-Olmo
Omental torsion is an infrecuent cause of acute abdomen. It is related to obesity, abdominal surgery and abdominal trauma. Urgent exploratory laparotomy allows diagnosis and prevents complications as intrabdominal abcess. We present CT imaging of a Omenat torsion clinical case.
May 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28479434/giant-infrarenal-aortic-aneurysm-rupture-preceded-by-left-lower-limb-motor-deficit
#17
Sasarman Vasile Aurelian, Molnar Adrian, Andercou Aurel, Schjoth Bruno, Oprea Alexandru, Trifan Catalin, Bindea Dan
This report presents the surgical repair and postsurgical outcomes following a ruptured infrarenal aortic aneurysm with a maximum transverse diameter of 20 cm. Its association with acute lower limb motor deficit is rare. Open surgery of giant abdominal aortic aneurysms is often the only available treatment, favored over an endovascular approach in the presence of increased aneurysm size with dislodged abdominal organs, adhesions, and short and angled proximal infrarenal aortic neck, presenting significant additional surgical and anesthesiological challenges...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28478913/visceral-and-gastrointestinal-complications-in-robotic-urologic-surgery
#18
G Velilla, C Redondo, R Sánchez-Salas, F Rozet, X Cathelineau
INTRODUCTION: with the widespread use of minimally invasive techniques, robot-assisted urologic surgery has become widely adopted. Despite their infrequency, visceral and gastrointestinal complications could be life-threatening. OBJECTIVES: To identify the main gastrointestinal injuries that occur in a robot-assisted urologic surgery. To know the overall incidence and how is their management. ACQUISITION OF THE EVIDENCE: Search in PubMed of articles related to visceral and gastrointestinal complications in robot-assisted urology surgery, written in English or Spanish...
May 4, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28474273/outpatient-appendectomy-in-an-emergency-outpatient-surgery-unit-24%C3%A2-h-a-day-an-intention-to-treat-analysis-of-194-patients
#19
Adeline Aubry, Arnaud Saget, Gilles Manceau, Matthieu Faron, Mathilde Wagner, Christophe Tresallet, Bruno Riou, Olivier Lucidarme, Frédéric le Saché, Mehdi Karoui
OBJECTIVE: To evaluate the feasibility and outcomes of patients operated on for uncomplicated acute appendicitis (UAA) in our 24-h emergency outpatient surgery unit. METHODS: This was a prospective observational study with intention-to-treat (ITT) analysis. From 12/2013 to 03/2015, all consecutive patients admitted for acute appendicitis (AA) were prospectively screened. A computed tomography or abdominal ultrasound confirmed the diagnosis of AA. Eligibility criteria for outpatient appendectomy were: UAA, no comorbidity, no physical or mental condition preventing participation in the study, absence of pregnancy, age older than 15 years, an accompanying adult person available for the hospital discharge and place of residence within 1 h of our hospital...
May 4, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28473679/epiploic-appendagitis-an-uncommon-surgical-diagnosis
#20
A Michael, Y Zakry, H Hanif
Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients...
April 2017: Medical Journal of Malaysia
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