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Sample records for abdominal compartment syndrome

  1. [Intestinal occlusion and abdominal compartment syndrome (ACS)].

    Stagnitti, Franco

    2009-01-01

    Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving

  2. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    Smit, M.; Buddingh, K. T.; Bosma, B; Nieuwenhuijs, V B; Hofker, H.S.; Zijlstra, J.G.

    2016-01-01

    INTRODUCTION: Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS

  3. Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome

    2011-01-01

    AIM: To evaluate the therapeutic effects of abdominal decompression plus continuous regional arterial infusion (CRAI) via a drug delivery system (DDS) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS).

  4. Open abdomen procedure in managing abdominal compartment syndrome in a child with severe fungal peritonitis and sepsis after gastric perforation

    Wei Lai

    2016-04-01

    Full Text Available Abdominal compartment syndrome with increased abdominal pressure resulted in multi-organ dysfunctions can be lethal in children. The open abdomen procedure intentionally leaves the abdominal cavity open in patients with severe abdominal sepsis and abdominal compartment syndrome by temporarily relieving the abdominal pressure. We reported our experience of open abdomen procedure in successfully treating a 4-year old boy with abdominal compartment syndrome caused by severe fungal peritonitis and sepsis after gastric perforation.

  5. Strategies for modulating the inflammatory response after decompression from abdominal compartment syndrome

    Shah Shinil K; Jimenez Fernando; Letourneau Phillip A; Walker Peter A; Moore-Olufemi Stacey D; Stewart Randolph H; Laine Glen A; Cox Charles S

    2012-01-01

    Abstract Background Management of the open abdomen is an increasingly common part of surgical practice. The purpose of this review is to examine the scientific background for the use of temporary abdominal closure (TAC) in the open abdomen as a way to modulate the local and systemic inflammatory response, with an emphasis on decompression after abdominal compartment syndrome (ACS). Methods A review of the relevant English language literature was conducted. Priority was placed on articles publ...

  6. Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine

    Zhang, Min-Jie; Zhang, Guo-Lei; Yuan, Wen-Bin; Ni, Jun; Huang, Li-Feng

    2008-01-01

    AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber’s salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients.

  7. D-lactate is a valid biomarker of intestinal ischemia induced by abdominal compartment syndrome

    Nielsen, Casper; Kirkegård, Jakob; Erlandsen, Erland J;

    2015-01-01

    BACKGROUND: Intra-abdominal hypertension (IAH) often leads to abdominal compartment syndrome, which is followed by intestinal ischemia and associated with a high mortality. The diagnosis of abdominal compartment syndrome is difficult, and no valid biochemical markers are available. We conducted an...... group) without IAH. Blood samples were taken from the portal and jugular veins at 0, 60, 120, 180, and 240 min after insufflation of carbon dioxide, and concentrations of D-lactate and L-lactate in the two groups were compared using an unpaired t-test. RESULTS: The concentrations of D-lactate were......, respectively). Examination of the intestines revealed both macroscopic and microscopic signs of ischemia in all but one animal in the intervention group and only in one sham-pig. CONCLUSIONS: Our findings suggest that D-lactate could be a useful biochemical marker of intestinal ischemia induced by IAH....

  8. Abdominal Compartment Syndrome and Necrotizing Pancreatitis Following Extracorporeal Shock Wave Lithotripsy.

    Gupta, S; Scambia, J; Gandillon, C; Aversano, F; Batista, R

    2016-09-01

    Extracorporeal shock wave lithotripsy (ESWL) is a common procedure in the treatment of renal calculi. There have been major complications reported with ESWL such as acute pancreatitis, bower perforation, venous thrombosis, and biliary obstruction. There are few reports in the literature of necrotizing pancreatitis secondary to ESWL. We have a case report of a 29-year-old female that developed an abdominal compartment syndrome with an acute necrotizing pancreatitis hours after extracorporeal shock wave lithotripsy. PMID:27462545

  9. Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes

    Shaheen, Aisha W.; Marie L Crandall; Nicolson, Norman G.; Smith-Singares, Eduardo; Merlotti, Gary J.; Jalundhwala, Yash; Issa, Nabil M.

    2016-01-01

    Context: Abdominal compartment syndrome (ACS) is associated with high morbidity and mortality among trauma patients. Several clinical and laboratory findings have been suggested as markers for ACS, and these may point to different types of ACS and complications. Aims: This study aims to identify the strength of association of clinical and laboratory variables with specific adverse outcomes in trauma patients with ACS. Settings and Design: A 5-year retrospective chart review was conducted at t...

  10. Evaluation of the relationship between pelvic fracture and abdominal compartment syndrome in traumatic patients

    Sheikhi Rahim Ali

    2013-01-01

    Full Text Available Introduction: An increase in abdominal pressure can lead to so-called intra-abdominal compartment syndrome (ACS. Multiple factors such as an increase in retroperitoneal volume due to pancreatitis, bleeding and edema as a result of pelvic fracture can lead to compartment syndrome. Prevention is better than cure in compartment syndrome. By measuring the intra-abdominal pressure (IAP through the bladder, a quick and accurate assessment of abdominal pressure is achieved. Therefore, this study aimed to evaluate the relationship between pelvic fracture and ACS in traumatic patients. Materials and Methods: This research was a descriptive-analytical study conducted on 100 patients referring to the Shiraz Nemazee Hospital in 2010. IAP was monitored every 4 h in patients suspected to be at high risk for ACS, e.g., those undergoing severe abdominal trauma and pelvic fracture. The IAP was measured via the urinary bladder using the procedure described by Kron et al. Data collected were analyzed using SPSS software. Results: The findings showed that ACS occurred in 28 of 100 patients. With regard to the associated injuries with abdominal trauma, 19% of all patients and 46/42% of the patients with ACS had pelvic fracture. Chi-square test revealed a significant relationship between pelvic fracture and incidence rate of ACS ( P < 0.001. Conclusions: According to the collected data, pelvic fracture due to a trauma can be one of the important causes of an increase in IAP and ACS. In this lethal condition, prevention is better than cure. Therefore, serial measurement of IAP through the bladder in high-risk patients (those with pelvic fracture by trauma is recommended to the nurses to diagnose this condition and to decrease the incidence of mortality.

  11. Acute renal failure due to abdominal compartment syndrome: report on four cases and literature review

    Cleva Roberto de

    2001-01-01

    Full Text Available We report on 4 cases of abdominal compartment syndrome complicated by acute renal failure that were promptly reversed by different abdominal decompression methods. Case 1: A 57-year-old obese woman in the post-operative period after giant incisional hernia correction with an intra-abdominal pressure of 24 mm Hg. She was sedated and curarized, and the intra-abdominal pressure fell to 15 mm Hg. Case 2: A 73-year-old woman with acute inflammatory abdomen was undergoing exploratory laparotomy when a hypertensive pneumoperitoneum was noticed. During the surgery, enhancement of urinary output was observed. Case 3: An 18-year-old man who underwent hepatectomy and developed coagulopathy and hepatic bleeding that required abdominal packing, developed oliguria with a transvesical intra-abdominal pressure of 22 mm Hg. During reoperation, the compresses were removed with a prompt improvement in urinary flow. Case 4: A 46-year-old man with hepatic cirrhosis was admitted after incisional hernia repair with intra-abdominal pressure of 16 mm Hg. After paracentesis, the intra-abdominal pressure fell to 11 mm Hg.

  12. Secondary abdominal compartment syndrome required decompression laparotomy during minimally invasive mitral valve repair.

    Nishi, Hiroyuki; Toda, Koichi; Miyagawa, Shigeru; Yoshikawa, Yasushi; Fukushima, Satsuki; Yoshioka, Daisuke; Saito, Tetsuya; Sawa, Yoshiki

    2016-12-01

    We treated a 77-year-old patient with secondary abdominal compartment syndrome that caused failure to maintain cardiopulmonary bypass while undergoing elective minimally invasive right mini-thoracotomy mitral valve and tricuspid valve repair procedures. During the operation, a decompression laparotomy was needed to relieve elevated intraabdominal pressure that caused instability of the cardiopulmonary bypass. Due to poor oxygenation and the long cardiopulmonary bypass time, the patient required peripheral extracorporeal membrane oxygenation before recovery. We alert surgeons to this rare complication that can occur even in patients undergoing minimally invasive surgery with a right mini-thoracotomy. PMID:26943679

  13. The Abdomen in “Thoracoabdominal” Cannot Be Ignored: Abdominal Compartment Syndrome Complicating Extracorporeal Life Support

    Arthur J. Lee

    2014-01-01

    Full Text Available Extracorporeal life support (ECLS is an incredible life-saving measure that is being used ever more frequently in the care of the critically ill. Management of these patients requires extreme vigilance on the part of the care providers in recognizing and addressing the complications and challenges that may arise. We present a case of overt abdominal compartment syndrome (ACS in a previously well young male on ECLS with a history of trauma, submersion, hypothermia, and no intra-abdominal injuries. The patient developed ACS soon after ECLS was initiated which resulted in drastically compromised flow rates. Taking into account the patient’s critical status, an emergent laparotomy was performed in the intensive care unit which successfully resolved the ACS and restored ECLS flow. The patient had an unremarkable course following and was weaned off ECLS but unfortunately died from his original anoxic injury. This case highlights several salient points: first, care of patients on ECLS is challenging and multiple etiologies can affect our ability to manage these patients; second, intra-abdominal pressures should be monitored liberally in the critically ill, especially in patients on ECLS; third, protocols for emergent operative treatment outside of traditional operating rooms should be established and care providers should be prepared for these situations.

  14. Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

    Sugrue, Michael

    2012-01-31

    BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.

  15. EARLY SURGERY TO PATIENTS SUFFERING FULMINANT ACUTE PANCREATITIS WITH ABDOMINAL COMPARTMENT SYNDROME

    YU Xiao; LI Yong-guo; CHEN Dao-jin; LI Xiao-rong; ZHANG Sheng-dao; LEI Ruo-qing; TANG Yao-qing

    2006-01-01

    Objective To retrospectively analyze and compare conservative versus surgical treatment of patients with fulminant acute pancreatitis (FAP) plus abdominal compartment syndrome (ACS). Methods From January 1998 to September 2005, 21 patients with FAP plus ACS were retrospectively analyzed. Ten patients were conservatively treated by means of intensive care medicine without surgery, and 11 patients received open surgical management and suction drainage. Results Seven of the 10 non-surgical patients died, comprising one with mild, four with moderate and two with severe ACS (70% mortality rate). Of the 11 patients receiving open surgical management in the early phase (within 3 days of disease initiation), three died, comprising one with moderate and two with severe ACS (27.3% mortality rate). The difference in mortality rates was found to be statistically significant. Conclusion Our data indicate patients suffering FAP with severe ACS should be treated with open management of the abdomen in the early phase (within 3 days), even in the absence of infection. This approach appears superior to that of conservative management. Surgical treatment resulted in abdominal decompression and subsequently significantly decreased the mortality rate and improved overall prognosis.

  16. Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective

    Dejan V. Radenkovic

    2016-01-01

    Full Text Available Abdominal compartment syndrome (ACS in patients with severe acute pancreatitis (SAP is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment.

  17. Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective.

    Radenkovic, Dejan V; Johnson, Colin D; Milic, Natasa; Gregoric, Pavle; Ivancevic, Nenad; Bezmarevic, Mihailo; Bilanovic, Dragoljub; Cijan, Vladimir; Antic, Andrija; Bajec, Djordje

    2016-01-01

    Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment. PMID:26839539

  18. Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes

    Shaheen, Aisha W.; Crandall, Marie L.; Nicolson, Norman G.; Smith-Singares, Eduardo; Merlotti, Gary J.; Jalundhwala, Yash; Issa, Nabil M.

    2016-01-01

    Context: Abdominal compartment syndrome (ACS) is associated with high morbidity and mortality among trauma patients. Several clinical and laboratory findings have been suggested as markers for ACS, and these may point to different types of ACS and complications. Aims: This study aims to identify the strength of association of clinical and laboratory variables with specific adverse outcomes in trauma patients with ACS. Settings and Design: A 5-year retrospective chart review was conducted at three Level I Trauma Centers in the City of Chicago, IL, USA. Subjects and Methods: A complete set of demographic, pre-, intra- and post-operative variables were collected from 28 patient charts. Statistical Analysis: Pearson's correlation coefficient was used to determine the strength of association between 29 studied variables and eight end outcomes. Results: Thirty-day mortality was associated strongly with the finding of an initial intra-abdominal pressure >20 mmHg and moderately with blunt injury mechanism. A lactic acid >5 mmol/L on admission was moderately associated with increased blood transfusion requirements and with acute renal failure during the hospitalization. Developing ACS within 48 h of admission was moderately associated with increased length of stay in the Intensive Care Unit (ICU), more ventilator days, and longer hospital stay. Initial operative intervention lasting more than 2 h was moderately associated with risk of developing multi-organ failure. Hemoglobin level 7 days were moderately associated with a disposition to long-term support facility. Conclusions: Clinical and lab variables can predict specific adverse outcomes in trauma patients with ACS. These findings may be used to guide patient management, improve resource utilization, and build capacity within trauma centers. PMID:27162436

  19. Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes

    Aisha W Shaheen

    2016-01-01

    Full Text Available Context: Abdominal compartment syndrome (ACS is associated with high morbidity and mortality among trauma patients. Several clinical and laboratory findings have been suggested as markers for ACS, and these may point to different types of ACS and complications. Aims: This study aims to identify the strength of association of clinical and laboratory variables with specific adverse outcomes in trauma patients with ACS. Settings and Design: A 5-year retrospective chart review was conducted at three Level I Trauma Centers in the City of Chicago, IL, USA. Subjects and Methods:A complete set of demographic, pre-, intra- and post-operative variables were collected from 28 patient charts. Statistical Analysis:Pearson's correlation coefficient was used to determine the strength of association between 29 studied variables and eight end outcomes. Results: Thirty-day mortality was associated strongly with the finding of an initial intra-abdominal pressure >20 mmHg and moderately with blunt injury mechanism. A lactic acid >5 mmol/L on admission was moderately associated with increased blood transfusion requirements and with acute renal failure during the hospitalization. Developing ACS within 48 h of admission was moderately associated with increased length of stay in the Intensive Care Unit (ICU, more ventilator days, and longer hospital stay. Initial operative intervention lasting more than 2 h was moderately associated with risk of developing multi-organ failure. Hemoglobin level 7 days were moderately associated with a disposition to long-term support facility. Conclusions: Clinical and lab variables can predict specific adverse outcomes in trauma patients with ACS. These findings may be used to guide patient management, improve resource utilization, and build capacity within trauma centers.

  20. Melanocortin MC4 receptor agonists alleviate brain damage in abdominal compartment syndrome in the rat.

    Liu, Dong; Zhang, Hong-Guang; Zhao, Zi-Ai; Chang, Ming-Tao; Li, Yang; Yu, Jian; Zhang, Ye; Zhang, Lian-Yang

    2015-02-01

    Intra-abdominal hypertension (IAH) is accompanied by high morbidity and mortality in surgical departments and ICUs. However, its specific pathophysiology is unclear. IAH not only leads to intra-abdominal tissue damage but also causes dysfunction in distal organs, such as the brain. In this study, we explore the protective effects of melanocortin 4 receptor agonists in IAH-induced brain injury. The IAH rat models were induced by hemorrhagic shock/resuscitation (with the mean arterial pressure (MAP) maintained at 30 mm Hg for 90 min followed by the reinfusion of the withdrawn blood with lactated Ringer's solution). Then, air was injected into the peritoneal cavity of the rats to maintain an intra-abdominal pressure of 20 mm Hg for 4 h. The effects of the melanocortin 4 receptor agonist RO27-3225 in alleviating the rats' IAH brain injuries were observed, which indicated that RO27-3225 could reduce brain edema, the expressions of the IL-1β and TNF-α inflammatory cytokines, the blood-brain barrier's permeability and the aquaporin4 (AQP4) and matrix metalloproteinase 9 (MMP9) levels. Moreover, the nicotinic acetylcholine receptor antagonist chlorisondamine and the selective melanocortin 4 receptor antagonist HS024 can negate the protective effects of the RO27-3225. The MC4R agonist can effectively reduce the intracerebral proinflammatory cytokine gene expression and alleviate the brain injury caused by blood-brain barrier damage following IAH. PMID:25616531

  1. Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Association with Ruptured Abdominal Aortic Aneurysm in the Endovascular Era: Vigilance Remains Critical

    Matthew C. Bozeman

    2012-01-01

    In this review, we describe published experience with IAH and ACS complicating abdominal vascular catastrophes, experience with ACS complicating endovascular repair of rAAAs, and techniques for management of the abdominal wound. Vigilance and appropriate management of IAH and ACS remains critically important in decreasing morbidity and optimizing survival following catastrophic intra-abdominal vascular events.

  2. Manuseio da síndrome compartimental abdominal em unidade de tratamento intensivo Intensive care management of the abdominal compartment syndrome

    Luiz Carlos Von Bahten

    2006-06-01

    Full Text Available A síndrome compartimental abdominal (SCA decorre de um aumento agudo na pressão intra-abdominal (PIA, promovendo alterações fisiológicas adversas devido ao acometimento dos principais sistemas orgânicos, podendo levar a falência orgânica e óbito. OBJETIVO: Avaliar a SCA em pacientes com hipertensão intra-abdominal (HIA admitidos na unidade de terapia intensiva (UTI. MÉTODO: Foi realizado um estudo de 548 pacientes submetidos a laparotomia, necessitando de UTI, durante o período de janeiro de 1997 a março de 2001. RESULTADOS: A SCA foi identificada em 29 pacientes (5,29%. Analisando-se o valor máximo de PIA, 9 (31,03% foram grau II, 10 (34,48% foram grau III e 10 (34,48% foram grau IV. Dezoito (62,07% foram reoperados e o fechamento temporário foi realizado em 6 (20,69%. A mortalidade global foi de 68,97%, sendo que a SCA grau II teve 55,56% de mortalidade; a de grau III, 50%; a de grau IV, 100% e a mortalidade dos pacientes reoperados, 61,11%. CONCLUSÕES: A SCA acarreta elevada mortalidade, mesmo com a reoperação precoce e adequado manejo em UTI, devendo-se manter maiores cuidados na sua identificação e prevenção.Abdominal compartment syndrome (ACS is attributed to acute increase in the intra-abdominal pressure (IAP, leading to adverse physiologic alterations because of involving the main organic systems and can lead to organic failure and obit. BACKGROUND: the purpose of this work is to evaluate the intra-abdominal hypertension (IAH and ACS conduct in patients submitted to intensive care unit (ICU. METHODS: in this retrospective work were analysed 548 patients submitted to laparotomy and ICU, during the period from 1997, january to 2001, march. RESULTS: ACS was noted in 29 patients (5.29%. Analysing the maximum IAP value, 9 (31.03% were grade II, 10 (34.48% were grade III and 10 were grade IV. Eighteen (62.07% were submitted to reoperation and temporary closure was used in 6 (20.69%. The global mortality was 68.97%, the

  3. Compartment syndrome without pain!

    O'Sullivan, M J

    2012-02-03

    We report the case of a young male patient who underwent intra-medullary nailing for a closed, displaced mid-shaft fracture of tibia and fibula. He was commenced on patient controlled analgesia post-operatively. A diagnosis of compartment syndrome in the patient\\'s leg was delayed because he did not exhibit a pain response. This ultimately resulted in a below-knee amputation of the patient\\'s leg. We caution against the use of patient controlled analgesia in any traumatised limb distal to the hip or the shoulder.

  4. Abdominal Pain Syndrome

    ... inspection of a drop of urine), and urine culture for bacterial infection. Stools can be analyzed for ... Hepatitis C Inflammatory Bowel Disease Irritable Bowel Syndrome Obesity Digestive Health Topics Abdominal Pain Syndrome Belching, Bloating, ...

  5. Establishment of an abdominal compartment syndrome animal model%腹腔间隔室综合征动物模型的构建特点

    畅庚云; 梅铭惠

    2012-01-01

    背景:腹腔间隔室综合征导致多器官功能损害的具体机制尚不十分清楚,为深入研究其发病机制及病理生理过程,需要合适的动物模型.目的:就腹腔间隔室综合征动物模型的制备过程中可能遇到的相关问题进行讨论,包括制备模型的标准、方法、动物的选择及监测腹压的方式.方法:由第一作者检索PubMed数据及CNKI数据库1990/2011有关腹腔间隔室综合征及腹腔高压及相关动物模型方面的文献.结果与结论:一个成功的腹腔间隔室综合征动物模型最好能保持腹腔压力的稳定,并能持续一定的时间,同时尽可能少的影响实验结果.所以无论选择腹腔灌注气体还是灌注液体模型的测量腹腔内压并维持压力的稳定是关键.腹腔灌注液体模型无法动态监测腹压,且压力波动较大,与之相比腹腔灌注气体模型测压较为方便,若使用电子供气系统动态监测则更为理想.生理模型是前瞻性的实验,但现有的生理模型有待改进.%BACKGROUND:The mechanism of organ functional lesion cause by abdominal compartment syndrome (ACS) is unclear. The appropriate animal models should be established for the in-depth study of the pathogenesis and pathophysiology.OBJECTIVE: To investigate the related issues you might encounter during the process, including the model preparation standard,method, animal se lection and monitoring of abdominal pressure.METHODS: The PubMed database and CNKI database from 1990 to 2011 were used to search the articles on ACS, abdominalhigh pressure and related animal model.RESULTS AND CONCLUSION: A successful animal model of ACS should have to maintain the stability of intra -abdominalpressure, and can persist for some time. Meanwhile it should impact on the experimental results as little as possible. Therefore,the key is the measurement of the intra -abdominal pressure in intraperitoneal infusion of liquid of gas model as well as themaintenance of a

  6. COMPARTMENT SYNDROME IN TRAUMA PATIENTS

    Alexander Beck

    2007-07-01

    Full Text Available Acute limb compartment syndrome (LCS is a limb-threatening and occasionally life-threatening condition caused by bleeding or edema in a closed muscle compartment surrounded by fascia and bone, which leads to muscle and nerve ischemia. Well-known causative factors are acute trauma and reperfusion after treatment for acute arterial obstruction. Untreated compartment syndrome usually leads to muscle necrosis, limb amputation, and, if severe, in large compartments, renal failure and death. Alertness, clinical suspicion of the possibility of LCS, and occasionally intracompartmental pressure (ICP measurement are required to avoid a delay in diagnosis or missed diagnosis. Open fasciotomy, by incising both skin and fascia, is the most reliable method for adequate compartment decompression. The techniques of measuring ICP have advantages and disadvantages, whereas the pressure level that mandates fasciotomy is controversial. Increased awareness of the syndrome and the advent of measurements of ICP pressure have raised the possibility of early diagnosis and treatment. This presentation reports LCS, including etiology, diagnosis, ICP measurement, management, and outcome.

  7. Consecuencias hemodinámicas y respiratorias del síndrome compartimental abdominal en un modelo experimental Hemodynamic and respiratory alterations in an experimental abdominal compartment syndrome model

    Franco Díaz R

    2012-10-01

    Full Text Available Introducción: El síndrome compartimental abdominal (SCA es una entidad grave, de escaso reporte en población pediátrica por una inadecuada alerta y reconocimiento. Puede ser originado por causas médicas y quirúrgicas, presentando una elevada mortalidad. objetivo: Determinar la magnitud de las consecuencias hemodinámicas y respiratorias iniciales desencadenadas por la inducción de un SCA en un modelo experimental. Método: Doce cerdos anestesiados (4,8 ± 0,1 kg. El SCA fue inducido con instilación de solución coloide en cavidad peritoneal para obtener una presión intra-abdominal (PIA de 25 ± 5 mmHg. En condiciones basales y posterior a inducción del SCA se realizó monitorización hemodinámica convencional y termodilución transpulmonar. Paralelamente se midió gasometría arterial y análisis de mecánica pulmonar. resultados: Hubo una reducción del gasto cardíaco en 16% (5,19 ± 0,33 a 4,34 ± 0,28 l/min/m², p = 0,01 y de la presión de perfusión abdominal en 20% (72,3 ± 3,2 a 57,3 ± 4,0 mmHg, p Introduction: Abdominal compartment syndrome (ACS is a severe and under-reported condition among the pediatric population due to inadequate warning and recognition. It can be caused by medical and surgical reasons, resulting in a high mortality rate. objective: To determine the magnitude of the initial hemodynamic and respiratory consequences triggered by the induction of ACS in an experimental model. Methods: The model consisted of twelve anesthetized pigs (4.8 ± 0.1 kg. The ACS was induced by instillation of colloid solution in the peritoneal cavity to obtain an intra-abdominal pressure (IAP of 24.9 ± 0.6 mmHg. In basal conditions and after the ACS induction, a conventional hemodynamic monitoring and transpulmonary thermodilution were performed. At the same time, arterial blood gases and lung mechanics analysis were measured. results: There was a reduction of cardiac output by 16% (5.19 ± 0.33 to 4.34 ± 0.28 l/min/m², p = 0

  8. Compartment syndrome in a labrador retriever

    Compartment syndrome is an elevation of interstitial pressure in a closed osseofascial compartment that results in microvascular compromise. This report documents a clinical syndrome in the crus of a fourteen-month-old intact male Labrador Retriever which was consistent with trauma-induced compartment syndrome. A six month history of recurring trauma or complications resulted in the need for referral. Survey radiography and ultrasonography aided in the diagnosis, but the definitive answer was provided by femoral angiography. The patient was successfully treated and was discharged with normal limb function. One year later, there were no complications observed. Compartment syndrome is not uncommon in humans, and is routinely considered in certain blunt and most penetrating traumas. However, few reports of this complication in animals are found

  9. Cutaneous anthrax cases leading compartment syndrome

    Emine Parlak; Ali Aydın; Mehmet Parlak

    2013-01-01

    Bacillus anthracis is the causative agent of anthrax. Anthrax is a zoonotic disease with three clinical forms. Clinical forms are skin, gastrointestinal and inhalational anthrax. Cutaneous anthrax is 95% of the cases. Cutaneous anthrax frequently defines itself. Clinical presentation of anthrax may be severe and complicated in some cases. There may seem complications like meningitis, septic shock and compartment syndrome. Compartment Syndrome is a rare complication of cutaneous anthrax ...

  10. Compartment Syndrome Resulting from Carbon Monoxide Poisoning.

    Serbest, Sancar; Belhan, Oktay; Gürger, Murat; Tosun, Haci Bayram

    2015-12-01

    Every year, especially in the cooler Fall and Winter months, hundreds of people die because of carbon monoxide poisoning. This occurs usually as an accident. It is a significant cause of poisoning worldwide. We present a case of compartment syndrome in both lower extremities with accompanying acute renal failure and systemic capillary leakage syndrome because of carbon monoxide poisoning. PMID:26588033

  11. Cutaneous anthrax cases leading compartment syndrome

    Emine Parlak

    2013-12-01

    Full Text Available Bacillus anthracis is the causative agent of anthrax. Anthrax is a zoonotic disease with three clinical forms. Clinical forms are skin, gastrointestinal and inhalational anthrax. Cutaneous anthrax is 95% of the cases. Cutaneous anthrax frequently defines itself. Clinical presentation of anthrax may be severe and complicated in some cases. There may seem complications like meningitis, septic shock and compartment syndrome. Compartment Syndrome is a rare complication of cutaneous anthrax and it is life threatening. Physicians working in the endemic area should be aware of this form. In this study, three cases were shown which developed compartment syndrome following cutaneous anthrax. J Microbiol Infect Dis 2013;3(4: 214-217

  12. Volume -controlled peritoneal drainage for acute ascites resulted abdominal compartment syndrome%控制引流治疗腹腔积液继发腹腔间隙综合征

    梁玉坚; 黄慧敏; 徐玲玲; 张丽丹; 李素萍; 唐雯

    2014-01-01

    目的:观察腹腔置管持续控制引流治疗急性腹腔积液所致儿童腹腔间隙综合征( abdominal compartment syndrome , ACS)的临床疗效。方法回顾性分析2011-05~2013-05收住中山大学附属第一医院PICU的12例急性腹腔积液所致儿童ACS采用腹腔持续置管控制性引流治疗的患儿,并与8例未能接受引流的急性腹腔积液所致儿童ACS病例进行对比。结果12例急性腹腔积液继发ACS 患儿中,病因为腹腔肿瘤破裂出血7例(7/12),肝肾移植术后3例(3/12),尿瘘致尿性腹水2例(2/12)。引流组在治疗前的腹腔压力、脏器受累数量及危重病评分与未引流组比较差异无统计学意义。在ACS患儿中,呼吸道及胃肠道为受累最多的器官,腹腔压力越高,脏器损害数量及病死率越高。引流组较未引流组死亡率明显降低(引流3/12 vs未引流8/8,P<0.001)。腹腔置管引流偶有发生腹腔感染和电解质紊乱的并发症。结论腹腔置管持续控制性引流是一个微创、高效而安全的治疗急性腹腔积液继发ACS的方法,能有效降低IAP,减少脏器损害的发生,大大降低了死亡率,为原发病的救治争取更多的时间。%Objective Intra -abdominal hypertension ( IAH ) has been identified as an independent risk factor for death .The primary goal of this study was to observe the effect of continuous volume -controlled percutaneous catheter drainage ( PCD ) for acute ascites resulted abdominal compartment syndrome ( ACS) .Methods We retrospectively analyzed the treatment effect of volume -controlled PCD in 12 patients with acute ascites resulted ACS from May 2011 to May 2013 in PICU. Eight patients who were treated without PCD were compared .Results Of these 12 enrolled children , 7 cases (7/12) were abdominal tumor rupture, 3 cases (3/12) were post -operation of liver or kidney transplantation and 2 cases ( 2/12 ) were urinary fistula

  13. 危重病患者胃肠道症状与腹腔间室综合征的相关性分析%Correlative study on gastrointestinal symptoms of severe eases and Abdominal compartment syndrome

    方桂珍; 葛琴灵

    2009-01-01

    Objective To explore the correlation of gastrointestinal symptom of severe cases and abdominal compartment syndrome (ACS),improve monitor technique. Methods Using descriptive study to do classified description according to the distribution of 384 severe cases' gastrointestinal symptom and using regressive analysis to analyze the dangerous factors of 46 cases who suffered ACS. Results ①The rate of gastrointestinal symptom of 46 cases with ACS:one case with nausea and vomiting occupied 2.2% ,45 cases with abdominal distension and pain occupied 97.8% ,45 cases with bowel sound occupied 97.8%,2 cases with diarrhea occupied 4.3%,45 cases with constipation occupied 97.8%. ②Aceording to the single factor logistic regressive analysis shows statistical significant symptoms relating to ACS as follows:abdominal distension and pain,bowel sound decline and constipation,etc. With multi-factors unconditional progressively logistic regressive analysis shows:the first dangerous factor of ACS is abdominal distension and pain(OR=259.106),then is bowel sound decline. Condusion The correlation exists between the gastrointestinal symptoms and ACS. The clinical nurses should pay attention to the monitor of gastrointestinal function so that the incidence of ACS can be reduced through promoting monitor skills.%目的 探讨危重病患者胃肠道症状与腹腔间室综合征间的相关性,提高对危重病患者早期胃肠功能改变的识别与监护.方法 采用描述性研究的方法,对384例危重患者胃肠道症状作分类描述.采用Logistic回归分析对其中发生腹腔间室综合征的46例进行危险因素分析.结果 ①46例并发腹腔阃室综合征患者的胃肠道症状其中,忍心呕吐1例(2.2%),腹胀腹痛45倒(97.8%).肠鸣音减弱45例(97.8%),腹泻2例(4.3%),便秘45例(97.8%).②单因素Logistic回归分析显示,对发生腹腔闹室综合征有统计学意义(P<0.01)的胃肠道症状为,腹胀腹痛、肠鸣音减弱、便秘3

  14. What's new in acute compartment syndrome?

    Harvey, Edward J; Sanders, David W; Shuler, Michael S; Lawendy, Abdel-Rahman; Cole, Ashley L; Alqahtani, Saad M; Schmidt, Andrew H

    2012-12-01

    Acute compartment syndrome (ACS) after trauma is often the result of increased size of the damaged tissues after acute crush injury or from reperfusion of ischemic areas. It usually is not solely caused by accumulation of free blood or fluid in the compartment, although that can contribute in some cases. There is no reliable and reproducible test that confirms the diagnosis of ACS. A missed diagnosis or failure to cut the fascia to release pressure within a few hours can result in severe intractable pain, paralysis, and sensory deficits. Reduced blood circulation leads to oxygen and nutrient deprivation, muscle necrosis, and permanent disability. Currently, the diagnosis of ACS is made on the basis of physical examination and repeated needle sticks over a short time frame to measure intracompartmental pressures. Missed compartment syndromes continue to be one of most common causes of malpractice lawsuits. Existing technology for continuous pressure measurements are insensitive, particularly in the deep tissues and compartments, and their use is restricted to highly trained personnel. Newer concepts of the pathophysiology accompanied by new diagnostic and therapeutic modalities have recently been advanced. Among these are the concept of inflammatory mediators as markers and anti-inflammatories as medical adjunct therapy. New diagnostic modalities include near-infrared spectroscopy, ultrafiltration catheters, and radio-frequency identification implants. These all address current shortcomings in the diagnostic armamentarium that trauma surgeons can use. The strengths and weaknesses of these new concepts are discussed to allow the trauma surgeon to follow current evolution of the field. PMID:22913965

  15. Compartment syndrome can also be seen in the forearm

    Asmar, Ali; Broholm, Rikke; Bülow, Jens; Simonsen, Lene

    2014-01-01

    Chronic compartment syndrome is a challenge for the clinician and symptomatic similar to neuropathies, tenosynovitis, stress fractures and referred pain from lumbar cervicalis. Thus, chronic compartment syndrome of the upper extremities is probably an underdiagnosed condition. In patients with st...... stress-induced pain in the upper limbs, chronic compartment syndrome should be considered - particularly in young patients with high physical activity. Despite limited literature, the effect of surgical treatment is promising.......Chronic compartment syndrome is a challenge for the clinician and symptomatic similar to neuropathies, tenosynovitis, stress fractures and referred pain from lumbar cervicalis. Thus, chronic compartment syndrome of the upper extremities is probably an underdiagnosed condition. In patients with...

  16. Síndrome de compartimento abdominal durante pinçamento por via endoscópica de perfuração intestinal secundária à colonoscopia Síndrome de compartimiento abdominal durante pinzamiento por vía endoscópica de perforación intestinal secundaria a la colonoscopia Abdominal compartment syndrome during endoscopic clamping of an intestinal perforation secondary to colonoscopy

    Magda Lourenço Fernandes

    2009-10-01

    ópica. El objetivo de este relato de caso, fue avisarles a los expertos sobre el aparecimiento y el tratamiento del síndrome de Compartimiento Abdominal durante el pinzamiento endoscópico de perforación intestinal secundario a la colonoscopia. RELATO DEL CASO: Paciente del sexo femenino, 60 años, estado físico ASA II, sometida a la colonoscopia bajo sedación. Durante el examen se comprobó la perforación accidental del intestino y se optó por tratar de pinzar la perforación por vía endoscópica. La paciente evolucionó con dolor y con una distensión abdominal, neumoperitoneo, síndrome de Compartimiento Abdominal, disnea e inestabilidad cardiovascular. Se realizó la punción abdominal de emergencia, lo que determinó la mejoría clínica de la paciente hasta que se hiciese la laparotomía de urgencia. Después de realizarla con exploración y con sutura de la perforación, la paciente evolucionó bien clínicamente. CONCLUSIONES: El pinzamiento por vía endoscópica de perforación intestinal secundaria a la colonoscopia, puede contribuir a la formación de neumoperitoneo hipertensivo y el síndrome de Compartimiento Abdominal, con repercusiones clínicas graves que exigen un tratamiento inmediato. Los profesionales capacitados y los recursos técnicos adecuados, pueden ser factores determinantes del pronóstico del paciente.BACKGROUND AND OBJECTIVES: Colonoscopy is widely used for diagnosis, treatment, and control of intestinal disorders. Intestinal perforation, although rare, is the most feared complication. Perforations can be treated by endoscopic clamping. The objective of this report was to alert specialists for the development and treatment of abdominal compartment syndrome during endoscopic clamping of an intestinal perforation secondary to colonoscopy. CASE REPORT: This is a 60 years old female, physical status ASA II, who underwent colonoscopy under sedation. During the exam, an accidental intestinal perforation was observed, and it was decided to

  17. Posterior compartment syndrome associated with clopidogrel therapy following trivial trauma

    Byrne, A‐M; Kearns, S. R.; Kelly, E P

    2006-01-01

    Haematomata caused by blunt trauma may potentially induce a compartment syndrome by raising intra‐compartmental pressure. We report a case of acute posterior compartment syndrome following minimal trauma to the leg of an elderly patient on the antiplatelet agent clopidogrel. This case highlights the high index of clinical suspicion required to detect compartment syndrome in those on long term antiplatelet therapy and prompt surgical decompression is recommended.

  18. The upper hand on compartment syndrome.

    Dolan, Roisin T

    2012-11-01

    Metacarpal fractures are common injuries, accounting for approximately 30% to 40% of all hand fractures and with a lifetime incidence of 2.5%. Traditionally regarded as an innocuous injury, metacarpal fractures tend to be associated with successful outcomes after closed reduction and immobilization. Hand compartment syndrome (HCS) is a rare clinical entity with potential devastating consequences in terms of loss of function and quality-of-life outcomes. We discuss the case of a 44-year-old woman presenting with multiple closed metacarpal fractures as a result of low-energy trauma, complicated by acute HCS. We review the presentation, clinical assessment, and optimal surgical management of acute HCS with reference to international literature.

  19. Mannitol extravasation during partial nephrectomy leading to forearm compartment syndrome

    Bradley A. Erickson

    2007-02-01

    Full Text Available We present the first known complication of forearm compartment syndrome after mannitol infusion during partial nephrectomy. We stress the importance of excellent intravenous catheter access and constant visual monitoring of the intravenous catheter site during and after mannitol infusion as ways to prevent this complication. Prompt recognition of compartment syndrome with appropriate intervention can prevent long-term sequelae.

  20. Fulminant crural compartment syndrome preceded by psychogenic polydipsia

    Ulstrup, Anton; Ugleholdt, Randi; Rasmussen, Jeppe Vejlgaard

    2015-01-01

    We report a case of bilateral anterolateral crural compartment syndrome elicited by hyponatraemia and psychogenic polydipsia. The unusual constellation of clinical findings and diminished pain expression made initial diagnostic procedures challenging. The possible pathogenesis and treatment options...

  1. Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty

    Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.

    2007-01-01

    Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not been reported previously after unicompartmental knee arthroplasty in the literature. Low level of suspicion may delay the diagnosis, as popliteal vascular injury and compartment syndrome are not well ...

  2. An iatrogenic popliteal pseudoaneurysm masked under compartment syndrome of leg.

    Sajjad, Jahangir; Coveney, Andrew; Ahmed, Abubakr; Fulton, Gregory

    2014-01-01

    This case describes a 60-year-old gentleman who presented with a pulsating mass behind his knee. Before this, he had a fasciotomy for suspected compartment syndrome of leg following knee arthroscopy, but this failed to resolve his leg symptoms. He was hemodynamically stable on presentation. His left calf was swollen with a circumference of 3 cm greater than right. There was a large pulsating mass palpable in his left popliteal fossa. Distal neurovascular status of the leg was intact. He had a normal cardiovascular, respiratory, abdominal and neurological examination. Ultrasound showed a cystic mass in the popliteal fossa suggestive of aneurysm. CT angiogram demonstrated a 6 × 5 × 4 cm pseudoaneurysm compressing and displacing the left popliteal artery with satisfactory three-vessel run-off. An emergency repair was performed. An arteriotomy was identified at the proximal end of pseudoaneurysm and it was closed with a patch of small saphenous vein. It led to a good clinical outcome. PMID:25362730

  3. [Compartment syndrome following laparoscopic procedures in the lithotomy position].

    Donckers, Janneke; de Kruif, Jan H; van der Stappen, William A H

    2010-01-01

    A laparoscopic tubectomy in the lithotomy position was performed on a healthy 31-year-old woman, as treatment following an extra-uterine pregnancy. The operation proceeded without complications and took 60 minutes. However, on the third day following surgery the woman was diagnosed with compartment syndrome, which was treated with three-compartment fasciotomy. Compartment syndrome is a rare but dangerous complication of an operation in the lithotomy position. Since pressure on leg compartments increases with time spent in the lithotomy position, regardless of the type of stirrups used, it is important to maintain the position only as long as is necessary for the procedure. The patient's legs should be taken out of the lithotomy position as soon as possible, and the position resumed if necessary at a later stage in the procedure. This can easily be achieved with pneumatic stirrups. PMID:20619013

  4. Acral osteolysis in bilateral compartment syndrome

    Iram Saeed

    2008-08-01

    Full Text Available Carpal tunnel syndrome is a common neurological condition with rare yet potentially serious cutaneous and skeletal complications. We present a case of mutilating/ulcerating bilateral carpal tunnel syndrome in a 63 year old female. Radiographs showed symmetrical acral osteolysis in the index and middle fingers distal phalanges bilaterally. Carpal tunnel decompressions provided symptomatic relief.

  5. Rare times rare: The hyponatremia, rhabdomyolysis, anterior compartment syndrome sequence

    Dubin, Ina; Gelber, Moshe

    2016-01-01

    Lesson Primary polydipsia occurs in up to 25% of patients with chronic psychiatric disorders (especially schizophrenia), related to the disease, its treatment or both. Urine output fails to match intake >10 L/day and water intoxication may develop. Rhabdomyolysis is a rare complication of hyponatremia, and an acute anterior compartment syndrome of the leg, an emergency, may be very rarely associated.

  6. Well-leg compartment syndrome after gynecological laparoscopic surgery

    Boesgaard-Kjer, Diana H; Boesgaard-Kjer, Daniel; Kjer, Jens Jørgen

    2013-01-01

    positioning of the legs during operation (lithotomy and Lloyd-Davies positions), a prolonged operation, external compression and vascular insults, both pre- and intra-operatively. To prevent well-leg compartment syndrome it is important to improve knowledge of the condition among surgeons and nursing staff...

  7. Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty

    Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.

    2007-01-01

    Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not bee

  8. "Compartment"-syndrom på underben, atypisk traumemekanisme

    Larsen, Michael H; Nielsen, Henrik Toft; Wester, Jens Ulrik

    2003-01-01

    Acute compartment syndrome (CS) is a limb threatening condition which warrants emergency treatment. We describe a case of a 37-year-old man with acute CS developed without major trauma. Early diagnosis and prompt treatment by decompressive fasciotomy is of vital importance in order to preserve li...

  9. Gluteal compartment syndrome after prostatectomy caused by incorrect positioning.

    Heyn, Jens; Ladurner, R; Ozimek, A; Vogel, T; Hallfeldt, K K; Mussack, T

    2006-04-28

    Gluteal compartment syndrome is an uncommon and rare disease. Most reasonable causes for the development of this disease are trauma, drug induced coma, Ehlers-Danlos syndrome, sickle cell associated muscle infarction, incorrect positioning during surgical procedures and prolonged pressure in patients with altered consciousness levels. The diagnosis requires a high index of suspicion, especially in postoperative patient where sedation or peridural anaesthesia can confound the neurological examination. Early signs include gluteal tenderness, decrease in vibratory sensation during clinical examination and increasing CK in laboratory findings. We present a case of a 52 year-old patient, who developed gluteal compartment syndrome after radical prostatectomy in lithotomic position. After operation, diuresis decreased [pain in the gluteal region and both thighs. His thighs and the gluteal region were swollen. Passive stretch of the thighs caused enormous pain. The compartment pressure was 92 mmHg. Therefore, emergency fasciotomy was performed successfully. The gluteal compartment syndrome was most likely caused by elevated pressure on the gluteal muscle during operation. We suggest heightened awareness of positioning the patient on the operating table is important especially in obese patients with lengthy operating procedures. PMID:16720283

  10. Pneumococcal sepsis presenting as acute compartment syndrome of the lower limbs: a case report

    Doddi Sudeendra; Singhal Tarun; Sinha Prakash

    2009-01-01

    Abstract Introduction Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. Spontaneous onset of acute compartment syndrome of the lower limbs is rare. We present a very rare case of pneumococcal sepsis leading to spontaneous acute compartment syndrome. Case presentation A 40-year-old Caucasian man presented as an emergency with spontaneous onset of pain in both legs and signs of compartment syndrome. This was confirmed on fasciotomy. Blood culture grew Streptococ...

  11. Methodological background and strategy for the 2012-2013 updated consensus definitions and clinical practice guidelines from the abdominal compartment society.

    Kirkpatrick, Andrew W; Roberts, Derek J; Jaeschke, Roman; De Waele, Jan J; De Keulenaer, Bart L; Duchesne, Juan; Bjorck, Martin; Leppäniemi, Ari; Ejike, Janeth C; Sugrue, Michael; Cheatham, Michael L; Ivatury, Rao; Ball, Chad G; Reintam Blaser, Annika; Regli, Adrian; Balogh, Zsolt; D'Amours, Scott; De Laet, Inneke; Malbrain, Manu L N G

    2015-01-01

    The Abdominal Compartment Society (www.wsacs.org) previously created highly cited Consensus Definitions/Management Guidelines related to intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Implicit in this previous work, was a commitment to regularly reassess and update in relation to evolving research. Two years preceding the Fifth World Congress on Abdominal Compartment Syndrome, an International Guidelines committee began preparation. An oversight/steering committee formulated key clinical questions regarding IAH/ /ACS based on polling of the Executive to redundancy, structured according to the Patient, Intervention, Comparator, and Outcome (PICO) format. Scientific consultations were obtained from Methodological GRADE experts and a series of educational teleconferences were conducted to educate scientific review teams from among the wscacs. org membership. Each team conducted systematic or structured reviews to identify relevant studies and prepared evidence summaries and draft Grades of Recommendation Assessment, Development and Evaluation (GRADE) recommendations. The evidence and draft recommendations were presented and debated in person over four days. Updated consensus definitions and management statements were derived using a modified Delphi method. A writingcommittee subsequently compiled the results utilizing frequent Internet discussion and Delphi voting methods to compile a robust online Master Report and a concise peer-reviewed summarizing publication. A dedicated Paediatric Guidelines Subcommittee reviewed all recommendations and either accepted or revised them for appropriateness in children. Of the original 12 IAH/ACS definitions proposed in 2006, three (25%) were accepted unanimously, with four (33%) accepted by > 80%, and four (33%) accepted by > 50%, but required discussion to produce revised definitions. One (8%) was rejected by > 50%. In addition to previous 2006 definitions, the panel also defined the open abdomen

  12. Opioid overdose with gluteal compartment syndrome and acute peripheral neuropathy

    Adrish, Muhammad; Duncalf, Richard; Diaz-Fuentes, Gilda; Venkatram, Sindhaghatta

    2014-01-01

    Patient: Male, 42 Final Diagnosis: Gluteal compartment syndrome • acute peripheral nauropathy Symptoms: — Medication: — Clinical Procedure: — Specialty: Critical Care Medicine Objective: Management of emergency care Background: Heroin addiction is common, with an estimated 3.7 million Americans reporting to have used it at some point in their lives. Complications of opiate overdose include infection, rhabdomyolysis, respiratory depression and central or peripheral nervous system neurological ...

  13. Pneumococcal sepsis presenting as acute compartment syndrome of the lower limbs: a case report

    Doddi Sudeendra

    2009-02-01

    Full Text Available Abstract Introduction Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. Spontaneous onset of acute compartment syndrome of the lower limbs is rare. We present a very rare case of pneumococcal sepsis leading to spontaneous acute compartment syndrome. Case presentation A 40-year-old Caucasian man presented as an emergency with spontaneous onset of pain in both legs and signs of compartment syndrome. This was confirmed on fasciotomy. Blood culture grew Streptococcus pneumoniae. Conclusion Sepsis should be strongly suspected in bilateral acute compartment syndrome of spontaneous onset.

  14. Common complication of crush injury, but a rare compartment syndrome

    Shaikh Nissar

    2010-01-01

    Full Text Available Compartment syndrome (CS is a common complication of crush injury but it is rare to find bilateral gluteal compartment syndrome (BGCS. Only six cases of BGCS have been reported in the literature. This syndrome has been reported after crush injury, drug overdose, surgical positioning, and vascular surgery. Apart from CS, crush injury is associated with multi-system adverse effects and these patients are at high risk for renal failure and sepsis. CS patients may present with dehydration; coagulation disorders; elevated creatine phosphokinase and myoglobin levels; hyperkalemia and hypocalcaemia, which may cause life-threatening arrhythmias and therefore need urgent and aggressive therapy. The early goal in these patients is prevention of acute renal failure with aggressive fluid therapy, alkalinization of urine, and forced diuresis. Early treatment of hyperkalemia, antibiotic therapy, immunoprophylaxis, and wound care will minimize the risk of arrhythmias and sepsis. CS must be considered when any patient is diagnosed with crush injury syndrome. CS is defined as elevation of interstitial/intracompartmental pressure, leading to microvascular and myoneural dysfunction and secondary hypoxia; it may cause functional loss or even death if not detected early and treated properly. The increase in pressure in one or all compartments of the gluteal region causes CS with devastating effects on muscle and neurovascular bundles. CS is traditionally diagnosed on the basis of five ′p′s: pain, pallor, paraesthesia, pulselessness and paralysis. Diagnosis of gluteal CS is difficult as the peripheral pulses are preserved and the condition is usually only diagnosed when neurological abnormality is noticed. Diagnosis of CS can be made by direct measurement of the compartment pressure and magnetic resonance imaging or computerized tomography. Gluteal CS is managed by fasciotomy and debridement of necrosed tissue, with secondary closure of fascia. A high index of

  15. Taurine inhibits ischemia/reperfusion-induced compartment syndrome in rabbits

    Ji-xian WANG; Yan LI; Li-ke ZHANG; Jing ZHAO; Yong-zheng PANG; Chao-shu TANG; Jing ZHANG

    2005-01-01

    Aim: To investigate effects of taurine on ischemia/reperfusion (I/R)-induced compartment syndrome in rabbit hind limbs.Methods: Rabbits underwent femoral artery occ lusion after ligation of branches from terminal aorta to femoral artery.After a 7-h ischemia, reperfusion was established with the use of heparinized by iv infusion 10 min before shunt placement.During reperfusion, anterior compartment pressure (ACP) was monitored continuously in the left lower extremity.Gastrocnemius muscle triphenyltetrazolium chloride (TTC) level, taurine content and myeloperoxidase activity were assayed.Oxidative stress was induced in the in vitro gastrocnemius muscle slices by free radical generating systems (FRGS),and the malondialdehyde content was measured in presence or absence of taurine.Results: After 7 h of ischemia, none of the parameters that we measured were different from those before ischemia, except that TTC reduction decreased by 80%.In the control group, after 2 h of reperfusion, ACP increased 4.5-fold, and gastrocnemius muscle taurine content was reduced by 33%.In taurine-treated animals, at 2 h reperfusion, the mean arterial blood pressure and heart rate were increased, by 6% and 10%.ACP decreased by 39%, muscle edema decreased by 16%, TTC reduction increased by 150%, and lactate dehydrogenase decreased by 36% compared to control group.Plasma and muscle taurine content increased by 70% and 88%, respectively.In the taurine-treated group, at 2 h reperfusion, plasma malondialdehyde and conjugated diene content were decreased by 38% and 23%,respectively, and muscle malondialdehyde and conjugated diene content decreased by 22% and 30%, respectively compared to the control group.At 2 h reperfusion,myeloperoxidase activity was increased 3.5-fold in control animals.In the in vitro study, taurine decreased malondialdehyde content in muscle slices incubated with hypochlorous acid in a dose-dependent manner, but there was no change when incubated with hydrogen peroxide and

  16. COMPARTMENTS

    Binder, Janos X; Pletscher-Frankild, Sune; Tsafou, Kalliopi;

    2014-01-01

    of the localization of a protein, it is thus necessary to consult multiple databases and prediction tools. To address this, we present the COMPARTMENTS resource, which integrates all sources listed above as well as the results of automatic text mining. The resource is automatically kept up to date...

  17. Delayed Presentation of Gluteal Compartment Syndrome: The Argument for Fasciotomy

    John E. Lawrence

    2016-01-01

    Full Text Available A male patient in his fifties presented to his local hospital with numbness and weakness of the right leg which left him unable to mobilise. He reported injecting heroin the previous morning. Following an initial diagnosis of acute limb ischaemia the patient was transferred to a tertiary centre where Computed Tomography Angiography was reported as normal. Detailed neurological examination revealed weakness in hip flexion and extension (1/5 on the Medical Research Council scale with complete paralysis of muscle groups distal to this. Sensation to pinprick and light touch was globally reduced. Blood tests revealed acute kidney injury with raised creatinine kinase and the patient was treated for rhabdomyolysis. Orthopaedic referral was made the following day and a diagnosis of gluteal compartment syndrome (GCS was made. Emergency fasciotomy was performed 56 hours after the onset of symptoms. There was immediate neurological improvement following decompression and the patient was rehabilitated with complete nerve recovery and function at eight-week follow-up. This is the first documented case of full functional recovery following a delayed presentation of GCS with sciatic nerve palsy. We discuss the arguments for and against fasciotomy in cases of compartment syndrome with significant delay in presentation or diagnosis.

  18. Acute Compartment Syndrome of the Foot due to Infection After Local Hydrocortisone Injection: A Case Report.

    Patil, Sampat Dumbre; Patil, Vaishali Dumbre; Abane, Sachin; Luthra, Rohit; Ranaware, Abhijit

    2015-01-01

    High-energy trauma associated with calcaneal fracture or Lisfranc fracture dislocation and midfoot crushing injuries are known causes of compartment syndrome in the foot. Suppurative infection in the deep osseofascial compartments can also cause compartment syndrome. We describe the case of a 29-year-old female who had developed a suppurative local infection that resulted in acute compartment syndrome after receiving a local hydrocortisone injection for plantar fasciitis. We diagnosed the compartment syndrome, and fasciotomy was promptly undertaken. After more than 2 years of follow-up, she had a satisfactory functional outcome without substantial morbidity. To our knowledge, no other report in the English-language studies has described compartment syndrome due to abscess formation after a local injection of hydrocortisone. The aim of our report was to highlight this rare, but serious, complication of a routine outpatient clinical procedure. PMID:24838218

  19. Marfan's syndrome and isolated aneurysm of the abdominal aorta.

    Van Ooijen, B.

    1988-01-01

    A 43 year old woman presented with an aneurysm of the abdominal aorta. Marfan's syndrome was diagnosed as the underlying cause of the aneurysm. An isolated aneurysm as presenting sign of Marfan's syndrome is rare. In a review of published reports about 30 cases were found.

  20. Slipping Rib Syndrome as Persistent Abdominal and Chest Pain.

    Bolaños-Vergaray, Juan Javier; de la Gala García, Francisco; Obaya Rebollar, Juan Carlos; Bové Alvarez, Maria

    2015-11-01

    Slipping rib syndrome is an overlooked cause of persistent abdominal or chest pain. The etiology of this syndrome is not well understood, but the characteristic pain is from hypermobility of the false ribs. Although it is a diagnosis of exclusion, misdiagnosis may lead to an excessive workup. A simple clinical examination via the hooking maneuver is the most significant feature of its diagnosis. We describe the case of a 41-year-old woman with slipping rib syndrome. PMID:26528703

  1. Acute Traumatic Compartment Syndrome in Pediatric Foot: A Systematic Review and Case Report.

    Wallin, Kelly; Nguyen, Hienvu; Russell, Lindsay; Lee, Daniel K

    2016-01-01

    Acute compartment syndrome of the lower leg and foot is a not widely reported, but serious, potential complication that can develop after fractures, crush injuries, or high-velocity trauma of the lower extremity. Early recognition and treatment are critical in preventing morbidity and permanent complications. Although compartment syndrome of the lower leg and foot has been well-studied and documented in adults, its occurrence in the pediatric population is rare. We performed a systematic review of the published data and present the case of the youngest patient with isolated ACS of the foot. A high index of suspicion is warranted in pediatric patients with a traumatic injury to the lower extremity for compartment syndrome. Inconclusive radiographic findings owing to skeletal immaturity and the inability to verbalize symptoms place young children at high risk of undiagnosed compartment syndrome. Clinicians should have a very low threshold for fasciotomy to prevent long-term sequelae associated with undiagnosed compartment syndrome. PMID:27067201

  2. An Abdominal Presentation of Churg-Strauss Syndrome

    J. R. E. Rees

    2010-01-01

    inflammation necrotising systemic vasculitis and necrotising glomerulonephritis. We describe a case of Churg-Strauss syndrome presenting with abdominal pain and later during the hospital admission a mono-neuritis multiplex syndrome affecting the lower limbs. The patient presented in such an atypical fashion with abdominal signs and symptoms that they required laparotomy and the diagnosis was made after histological examination of tissue taken at the time of surgery. Treatment with immunosuppression and aggressive rehabilitation achieved a progressive recovery which continued on discharge from hospital.

  3. Current concepts in the pathophysiology, evaluation, and diagnosis of compartment syndrome

    Hargens, A. R.; Mubarak, S. J.

    1998-01-01

    This article reviews present knowledge of the pathophysiology and diagnosis of acute compartment syndromes. Recent results using compression of legs in normal volunteers provide objective data concerning local pressure thresholds for neuromuscular dysfunction in the anterior compartment. Results with this model indicate that a progression of neuromuscular deficits occurs when IMP increases to within 35 to 40 mm Hg of diastolic blood pressure. These findings provide useful information on the diagnosis and compression thresholds for acute compartment syndromes. Time factors are also important, however, and usually are incompletely known in most cases of acute compartment syndrome. Although the slit catheter is a very good technique for monitoring IMP during rest, these catheters and their associated extracorporeal transducer systems are not ideal. Recently developed miniature transducer-tipped catheters and, perhaps, future development of noninvasive techniques may provide accurate recordings of IMP in patients with acute compartment syndromes.

  4. Acute lower limb compartment syndrome after Cesarean section: a case report

    Sütterlin Marc

    2011-04-01

    Full Text Available Abstract Introduction Acute compartment syndrome of the lower limb is a rare but severe intra- and post-partum complication. Prompt diagnosis is essential to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors can be helpful. Case presentation We present the case of a 32-year-old Caucasian woman with acute post-partum compartment syndrome. Conclusion Acute compartment syndrome is an important differential diagnosis for the sudden onset of intra- or post-partum lower-limb pain. Predisposing factors for the manifestation of acute compartment syndrome in an obstetric environment are augmented intra-partum blood loss, prolonged hypotensive episodes and the use of oxytocin to support or induce labor because of its vasoconstrictive properties. Treatment is prompt surgical decompression by performing fasciotomy in any affected muscular compartments.

  5. Chronic Renal Failure in a Patient Due to Gluteal Compartment Syndrome After a Nephrectomy Operation

    Özkan ULUTAŞ, , ,

    2013-09-01

    Full Text Available Gluteal compartment syndrome is a rare reason of rhabdomyolysis resulting from atraumatic origin, and leading to renal failure. Beside to other atraumatic causes like drug abuse, alcohol intoxication, and antihyperlipidemic medications prolonged operation duration in a fixed position is an important cause of this syndrome. Male sex, diabetes mellitus, hypertension and obesity are risk factors for gluteal compartment syndrome associated kidney failure. We report a 56 year old obese patient with a medical history of diabetes mellitus, and hypertension who undergo a nephrectomy operation resulting with gluteal compartment syndrome, and chronic kidney disease. We also highlight the importance of preventive cares and early recognition of gluteal compartment syndrome to avoid further morbidity.

  6. Magnetic Resonance Imaging of Changes in Abdominal Compartments in Obese Diabetics during a Low-Calorie Weight-Loss Program.

    Lena J Vogt

    Full Text Available To investigate changes in the fat content of abdominal compartments and muscle area during weight loss using confounder-adjusted chemical-shift-encoded magnetic resonance imaging (MRI in overweight diabetics.Twenty-nine obese diabetics (10/19 men/women, median age: 59.0 years, median body mass index (BMI: 34.0 kg/m2 prospectively joined a standardized 15-week weight-loss program (six weeks of formula diet exclusively, followed by reintroduction of regular food with gradually increasing energy content over nine weeks over 15 weeks. All subjects underwent a standardized MRI protocol including a confounder-adjusted chemical-shift-encoded MR sequence with water/fat separation before the program as well at the end of the six weeks of formula diet and at the end of the program at 15 weeks. Fat fractions of abdominal organs and vertebral bone marrow as well as volumes of visceral and subcutaneous fat were determined. Furthermore, muscle area was evaluated using the L4/L5 method. Data were compared using the Wilcoxon signed-rank test for paired samples.Median BMI decreased significantly from 34.0 kg/m2 to 29.9 kg/m2 (p 0.15. Visceral fat volume (3.2 L to 1.6 L, p < 0.001 and subcutaneous fat diameter (3.0 cm to 2.2 cm, p < 0.001 also decreased significantly. Muscle area declined by 6.8% from 243.9 cm2 to 226.8 cm2.MRI allows noninvasive monitoring of changes in abdominal compartments during weight loss. In overweight diabetics, weight loss leads to fat reduction in abdominal compartments, such as visceral fat, as well as liver fat and vertebral bone marrow fat while pancreas fat remains unchanged.

  7. Acute Abdominal Pain Secondary to Chilaiditi Syndrome

    Buicko, Jessica L.; Miguel Lopez-Viego; David Kang; Lopez, Michael A.; Pan, Andrew S.

    2013-01-01

    Chilaiditi syndrome is a rare condition occurring in 0.025% to 0.28% of the population. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Patients' symptoms can range from asymptomatic to acute intermittent bowel obstruction. Diagnosis is best achieved with CT imaging. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction. If the pat...

  8. Acute compartment syndrome after open forearm fracture – scale of the problem and case report

    Elsaftawy Ahmed

    2014-01-01

    Full Text Available Acute compartment syndrome is caused due to a sudden increase in the tissue pressure in a given fascial compartment. Missed and undiagnosed or not treated in time can lead to irreversible damage to limb muscles and nerves due to ischemia mechanism. This paper presents a case of a patient with an open forearm fracture treated conservatively in plaster.

  9. Stiffness and thickness of fascia do not explain chronic exertional compartment syndrome

    Dahl, Morten; Hansen, Philip; Stål, Per;

    2011-01-01

    Chronic exertional compartment syndrome is diagnosed based on symptoms and elevated intramuscular pressure and often is treated with fasciotomy. However, what contributes to the increased intramuscular pressure remains unknown....

  10. Acute Compartment Syndrome After Gastrocnemius Rupture (Tennis Leg) in a Nonathlete Without Trauma.

    Tao, Li; Jun, Huang; Muliang, Ding; Deye, Song; Jiangdong, Ni

    2016-01-01

    Acute compartment syndrome is a serious emergency that warrants urgent decompression, and tennis leg (i.e., rupture of the medial head of the gastrocnemius) is a known clinical condition that is usually treated symptomatically, with good results overall. In rare cases, acute compartment syndrome is associated with tennis leg after severe direct muscle trauma or severe exercise in athletes or physically active individuals. We present an unusual case of acute compartment syndrome secondary to tennis leg after the patient, a nonathlete, had disembarked from a truck without any trauma. Clinicians should have a high index of suspicion for atraumatic compartment syndrome, and timely surgical fasciotomy must be undertaken to avoid complications resulting from delayed diagnosis and treatment. PMID:25435006

  11. Bilateral medial foot compartment syndrome after an aerobics class: a case report.

    Lam, Suet Kam; McAlister, Jeffrey; Oliver, Noah; Pontell, David

    2012-01-01

    The authors present an unusual case of bilateral medial foot compartment syndrome in a healthy woman after a low-intensity aerobics exercise class. The majority of compartment syndrome cases have occurred after trauma, such as combat crush injuries and motor vehicle accidents. We wish to call attention to a rare situation in which compartment syndrome occurs in a healthy young adult after low-intensity exercise and highlight the necessity of a high clinical suspicion and a low threshold for fasciotomies to prevent irreversible muscle damage as a result of extremely high pressures. There is a paucity of cases on the clinical management and follow-up of this rare occurrence of compartment syndrome. PMID:22621857

  12. Acute Exertional Rhabdomyolysis and Triceps Compartment Syndrome During a High School Football Camp

    Oh, John Y.; Laidler, Matthew; Fiala, Steven C.; Hedberg, Katrina

    2012-01-01

    Background: Acute exertional rhabdomyolysis has been infrequently reported among adolescents. In August 2010, several high school football players from one team developed rhabdomyolysis and triceps compartment syndrome following an upper arm exercise held in a non-air-conditioned wrestling room. Purpose: To confirm the diagnoses, characterize the spectrum of illnesses, and determine the factors contributing to rhabdomyolysis and triceps compartment syndromes. Study Design: Descriptive epidemi...

  13. Bilateral calf chronic compartment syndrome in an elderly male: a case report.

    Siau, Keith

    2009-01-01

    Leg pain is a common presentation to the outpatient department. Bilateral calf chronic compartment syndrome is a rare cause of bilateral calf pain. Although this condition has been well documented in young athletes, it has rarely been reported in the elderly. We present the case of a 68-year-old male bodybuilder with bilateral calf chronic compartment syndrome, describe the presentation and evaluation of the condition, and provide a review of the literature herewith.

  14. Acute Abdominal Pain Secondary to Chilaiditi Syndrome

    Pan, Andrew S.; Lopez, Michael A.; Buicko, Jessica L.; Lopez-Viego, Miguel

    2013-01-01

    Chilaiditi syndrome is a rare condition occurring in 0.025% to 0.28% of the population. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Patients' symptoms can range from asymptomatic to acute intermittent bowel obstruction. Diagnosis is best achieved with CT imaging. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction. If the patient is symptomatic, treatment is usually conservative. Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management. PMID:23936720

  15. Acute Abdominal Pain Secondary to Chilaiditi Syndrome

    David Kang

    2013-01-01

    Full Text Available Chilaiditi syndrome is a rare condition occurring in 0.025% to 0.28% of the population. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Patients' symptoms can range from asymptomatic to acute intermittent bowel obstruction. Diagnosis is best achieved with CT imaging. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction. If the patient is symptomatic, treatment is usually conservative. Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management.

  16. Cauda equina syndrome presenting as abdominal pain: a case report.

    Ellanti, Prasad

    2012-09-01

    Cauda equina syndrome (CES) is an uncommon entity. Symptoms include bowel and bladder dysfunction, saddle anesthesia, and varying degrees of lower limb motor and sensory disturbances. The consequences of delayed diagnosis can be devastating, resulting in bowel and bladder incontinence and lower limb paralysis. There is little in literature regarding abdominal pain as a significant feature of the initial presentation of CES. We present the case of a 32-year-old woman with CES who presented to the emergency department with gradually worsening lower abdominal pain.

  17. Clinical pilot study for the automatic segmentation and recognition of abdominal adipose tissue compartments from MRI data

    Purpose: In the diagnosis and risk assessment of obesity, both the amount and distribution of adipose tissue compartments are critical factors. We present a hybrid method for the quantitative measurement of human body fat compartments. Materials and Methods: MRI imaging was performed on a 1.5 T scanner. In a pre-processing step, the images were corrected for bias field inhomogeneity. For segmentation and recognition a hybrid algorithm was developed to automatically differentiate between different adipose tissue compartments. The presented algorithm is designed with a combination of shape and intensity-based techniques. To incorporate the presented algorithm into the clinical routine, we developed a graphical user interface. Results from our methods were compared with the known volume of an adipose tissue phantom. To evaluate our method, we analyzed 40 clinical MRI scans of the abdominal region. Results: Relatively low segmentation errors were found for subcutaneous adipose tissue (3.56 %) and visceral adipose tissue (0.29 %) in phantom studies. The clinical results indicated high correlations between the distribution of adipose tissue compartments and obesity. Conclusion: We present an approach that rapidly identifies and quantifies adipose tissue depots of interest. With this method examination and analysis can be performed in a clinically feasible timeframe. (orig.)

  18. Magnetic Resonance Imaging of Changes in Abdominal Compartments in Obese Diabetics during a Low-Calorie Weight-Loss Program

    Lena J Vogt; Steveling, Antje; Meffert, Peter J.; Kromrey, Marie-Luise; Kessler, Rebecca; Hosten, Norbert; Krüger, Janine; Gärtner, Simone; Aghdassi, Ali A.; Mayerle, Julia; Lerch, Markus M.; Kühn, Jens-Peter

    2016-01-01

    Objectives To investigate changes in the fat content of abdominal compartments and muscle area during weight loss using confounder-adjusted chemical-shift-encoded magnetic resonance imaging (MRI) in overweight diabetics. Methods Twenty-nine obese diabetics (10/19 men/women, median age: 59.0 years, median body mass index (BMI): 34.0 kg/m2) prospectively joined a standardized 15-week weight-loss program (six weeks of formula diet exclusively, followed by reintroduction of regular food with grad...

  19. Intramuscular deoxygenation during exercise in patients who have chronic anterior compartment syndrome of the leg

    Mohler, L. R.; Styf, J. R.; Pedowitz, R. A.; Hargens, A. R.; Gershuni, D. H.

    1997-01-01

    Currently, the definitive diagnosis of chronic compartment syndrome is based on invasive measurements of intracompartmental pressure. We measured the intramuscular pressure and the relative oxygenation in the anterior compartment of the leg in eighteen patients who were suspected of having chronic compartment syndrome as well as in ten control subjects before, during, and after exercise. Chronic compartment syndrome was considered to be present if the intramuscular pressure was at least fifteen millimeters of mercury (2.00 kilopascals) before exercise, at least thirty millimeters of mercury (4.00 kilopascals) one minute after exercise, or at least twenty millimeters of mercury (2.67 kilopascals) five minutes after exercise. Changes in relative oxygenation were measured with use of the non-invasive method of near-infrared spectroscopy. In all patients and subjects, there was rapid relative deoxygenation after the initiation of exercise, the level of oxygenation remained relatively stable during continued exercise, and there was reoxygenation to a level that exceeded the pre-exercise resting level after the cessation of exercise. During exercise, maximum relative deoxygenation in the patients who had chronic compartment syndrome (mean relative deoxygenation [and standard error], -290 +/- 39 millivolts) was significantly greater than that in the patients who did not have chronic compartment syndrome (-190 +/- 10 millivolts) and that in the control subjects (-179 +/- 14 millivolts) (p < 0.05 for both comparisons). In addition, the interval between the cessation of exercise and the recovery of the pre-exercise resting level of oxygenation was significantly longer for the patients who had chronic compartment syndrome (184 +/- 54 seconds) than for the patients who did not have chronic compartment syndrome (39 +/- 19 seconds) and the control subjects (33 +/- 10 seconds) (p < 0.05 for both comparisons).

  20. Gluteal compartment syndrome due to prolonged immobilization after alcohol intoxication: a case report.

    Iizuka, Shinichi; Miura, Naoyuki; Fukushima, Tomokazu; Seki, Tomoko; Sugimoto, Katuhiko; Inokuchi, Sadaki

    2011-07-01

    Gluteal compartment syndrome is a relatively rare condition that mostly result from atraumatic causes such as prolonged immobilization due to drug abuse or alcoholic intoxication and incorrect positioning during surgical procedures rather than traumatic causes. Early diagnosis is difficult and sometimes delayed or overlooked because of poor physical signs resulting from altered mental status and inappropriate diagnosis by clinicians. It has been reported that more than half of the cases of gluteal compartment syndrome are associated with crush syndrome and sciatic nerve palsy. Early diagnosis and immediate fasciotomy are necessary to improve the functional prognosis. Here, we report the case of a patient with gluteal compartment syndrome caused by prolonged immobilization after acute alcoholic intoxication. After disease onset, the patient developed complications of crush syndrome and sciatic nerve palsy, but immediate fasciotomy improved his condition. PMID:21769768

  1. Compartment syndrome in a patient treated with perineural liposomal bupivacaine (Exparel).

    Soberón, José Raul; Sisco-Wise, Leslie E; Dunbar, Ross M

    2016-06-01

    Acute compartment syndrome is a condition that may result in sensorimotor deficits and loss of function of the affected limb as a result of ischemic injury. It is considered a surgical emergency and prompt diagnosis and treatment results in more favorable outcomes. The use of regional anesthesia is controversial in patients at risk for compartment syndrome due to concern of its potential to mask symptoms of the condition. A 44-year-old African American male presented to surgery for open reduction and internal fixation of a comminuted distal radius fracture. As part of an off-label, investigator-initiated, and institutional review board-approved study, he received a perineural injection of liposomal bupivacaine (Exparel) around the median, ulnar, and radial nerves at the level of the proximal forearm. The following morning, his initial complaints of numbness and incisional pain progressively evolved into worsening numbness, diffuse discomfort, and pain with passive movement. A diagnosis of compartment syndrome was made and he underwent an emergency fasciotomy. The diagnosis of compartment syndrome requires a high index of suspicion and prompt treatment. This patient's changing pattern of symptoms-rather than his pain complaints alone-resulted in the diagnosis of compartment syndrome treated with emergent fasciotomy in spite of finger numbness that was initially attributed to the liposomal bupivacaine. While the use of liposomal bupivacaine did not preclude the diagnosis of compartment syndrome in our patient, it should be used with caution in patients at risk for compartment syndrome until additional data, particularly regarding block characteristics, are available. PMID:27185666

  2. The diagnostic value of MRI scans for the diagnosis of chronic exertional compartment syndrome of the lower leg

    Objective. A prospective descriptive study to determine the value of magnetic resonance imaging (MRI) as an aid in diagnosing (chronic) exertional compartment syndrome.Design and patients. MRI was performed in 21 patients (41 anterior compartments) with chronic compartment syndrome at rest and following physical exercise. Median (T2-weighted) signal intensity on the MRI scan was determined in the anterior and the (superficial) posterior compartment of the lower leg before and after exercise. Postexercise increases in the signal intensity in these two compartments were compared. After fasciotomy, a second MRI scan was performed in 13 patients (25 anterior compartments) on the basis of the same protocol. MR studies were performed in 12 normal controls (24 anterior muscle compartments) on the basis of the same protocol.Results. T2-weighted signal intensity increased by 27.5% (range 13.6-38.6%) following exercise in the anterior compartment of patients with a chronic compartment syndrome. In the posterior compartment this increase amounted to 4.25% (range 0-10.2%). Following fasciotomy, the increase in the anterior compartment was 4.1% (range 1.0-5.2%), while the increase in the posterior compartment amounted to 5.6% (range 0-11.0%), In normal controls, the increase in the anterior compartment was 7.6% (range 0-9.1%), while in the posterior compartment it was 4.0% (range 0-7.2%).Conclusions. In patients with a chronic compartment syndrome, the affected (anterior) compartment shows a statistically significant increase in (T2-weighted) signal intensity during exercise compared with both the (superficial) posterior compartment and the anterior compartment of normal controls. This effect disappeared after fasciotomy. In view of the substantial increase in T2-weighted signal intensity, MRI can be used in diagnosing chronic compartment syndrome. (orig.)

  3. Abdominal syndromes and functional ability in the elderly

    Kay, L; Avlund, K

    1994-01-01

    Data concerning a random cohort of 1,119 70-year-old subjects were analyzed to evaluate the association between Upper Dyspepsia and Irritable Bowel Syndrome and functional ability. Seven hundred and thirty-four subjects were interviewed about abdominal symptoms and were visited at home by an...... occupational therapist who evaluated their functional ability. Among the survivors, 94% participated in a follow-up study five years later. Functional ability was registered on validated scales constructed for its measurement in a normal elderly population. It was found that both syndromes occurred more often...... among subjects with reduced functional ability. A significant association was found between the occurrence of Upper Dyspepsia and a reduction of mobility and lower limb function, and between reduced functional ability and Irritable Bowel Syndrome at the five-year follow-up. It is concluded that...

  4. Motorcycle racer with unilateral forearm flexor and extensor chronic exertional compartment syndrome.

    Winkes, Michiel B; Teijink, Joep A; Scheltinga, Marc R

    2016-01-01

    We discuss a case of a 26-year-old man, a motorcycle racer, who presented with progressive pain, weakness and swelling of his right forearm and loss of power in his index finger, experienced during motor racing. Chronic exertional compartment syndrome (CECS) of both flexor and extensor compartments of his forearm was diagnosed by dynamic intracompartmental muscle pressure measurements. After fasciotomies, all symptoms were resolved and the patient was able to improve on his preinjury racing skills, without any limitations. A literature review and a surgical 'how-to' for correct release of the extensor and deep flexor compartments of the forearm are provided. PMID:27080851

  5. Acute compartment syndrome of hand resulting from radiographic contrast iohexol extravasation

    Kolar Vishwanath Vinod

    2016-01-01

    Full Text Available Intravenous (IV administration of iodinated contrast agents (ICAs is frequently employed for image enhancement while performing radiographic studies such as computed tomography and angiography. Complications related to IV administration of ICAs such as immediate hypersensitivity reactions and nephrotoxicity are well-known. However, severe skin and soft tissue injuries and acute compartment syndrome resulting from contrast extravasation are rare. This is especially so with small volume extravasation of a low osmolar, nonionic ICA such as iohexol. Here, we report a 63-year-old woman who developed acute compartment syndrome of left hand following iohexol extravasation and had swelling, blistering, cutaneous and soft tissue necrosis. She underwent fasciotomy for acute compartment syndrome of hand and later surgical debridement of necrotic skin and soft tissues was carried out. Clinical pharmacology of ICAs, extravasation injuries following their IV administration, their management and measures to reduce them are discussed in brief.

  6. Systemic Capillary Leak Syndrome associated with hypovolemic shock and compartment syndrome. Use of transpulmonary thermodilution technique for volume management

    Schmid Roland M

    2010-07-01

    Full Text Available Abstract Systemic Capillary Leak Syndrome (SCLS is a rare disorder characterized by increased capillary hyperpermeability leading to hypovolemic shock due to a markedly increased shift of fluid and protein from the intravascular to the interstitial space. Hemoconcentration, hypoalbuminemia and a monoclonal gammopathy are characteristic laboratory findings. Here we present a patient who suffered from SCLS with hypovolemic shock and compartment syndrome of both lower legs and thighs. Volume and catecholamine management was guided using transpulmonary thermodilution. Extended hemodynamic monitoring for volume and catecholamine management as well as monitoring of muscle compartment pressure is of crucial importance in SCLS patients.

  7. [A case of acute renal failure following compartment syndrome after the surgery for femoral neck fracture].

    Koda, Kenichiro; Uzawa, Masashi; Ide, Yasuo; Harada, Masaki; Sanbe, Norie; Sugano, Takayuki; Satoh, Yasuo; Tagami, Megumi

    2013-02-01

    Compartment syndrome is known to develop after a prolonged surgery in the lithotomy position. We experienced acute renal failure following compartment syndrome after the surgery in hemilithotomy position. A 62-year-old man underwent a left hip fixation for femoral neck fracture. The surgical leg was placed into traction in a foot piece and the intact leg was placed in the hemilithotomy position. Because of the difficulty in repositioning and the trouble with fluoroscope, the surgery took over 5 hours. He suffered acute pain, swelling and spasm in his intact leg placed into hemilithotomy after the surgery. Creatine kinase, blood urea nitrogen and creatinine markedly increased and myoglobinuria was recognized. We diagnosed an acute renal failure following compartment syndrome and treated him in the ICU on close monitoring. In spite of the treatment with massive transfusion and diuretics, he needed hemodialysis twice and then his renal function improved. Prevention is most essential for compartment syndrome after a prolonged surgery in the lithotomy position. Risk factors should be recognized before surgery and appropriate action should be taken such as using Allen stirrups and avoiding hypotension, hypovolemia and the prolonged lithotomy position with exaggerated elevation of legs. PMID:23479927

  8. Lower extremity compartment syndrome in the setting of iliofemoral deep vein thrombosis, phlegmasia cerulea dolens and factor VII deficiency.

    Abdul, Wahid; Hickey, Ben; Wilson, Chris

    2016-01-01

    Acute compartment syndrome requires urgent fasciotomies to prevent irreversible muscle damage. We present a case of massive iliofemoral deep vein thrombosis (DVT) presenting as acute compartment syndrome. A healthy 21-year-old man presented with a 2-day history of worsening left leg pain with swelling and bluish discolouration. Clinical diagnosis of compartment syndrome secondary to phlegmasia cerulea dolens (PCD) was made and he underwent emergency fasciotomies. Postoperative venous duplex confirmed a massive iliofemoral DVT and intravenous heparin was started. Following skin grafting, the patient made a good recovery. Massive iliofemoral DVT is an uncommon cause of compartment syndrome and has been reported in lower limbs, secondary to PCD. Failure to treat early carries a high degree of morbidity, with amputation rates up to 50% and mortality rates between 25% and 40%. It is important to recognise compartment syndrome as an acute presentation of PCD. Urgent fasciotomies can prevent limb amputation and mortality. PMID:27113791

  9. Altered rectal sensory response induced by balloon distention in patients with functional abdominal pain syndrome

    Kudaira Miwako; Nozu Tsukasa

    2009-01-01

    Abstract Background Functional abdominal pain syndrome (FAPS) has chronic unexplained abdominal pain and is similar to the psychiatric diagnosis of somatoform pain disorder. A patient with irritable bowel syndrome (IBS) also has chronic unexplained abdominal pain, and rectal hypersensitivity is observed in a majority of the patients. However, no reports have evaluated the visceral sensory function of FAPS precisely. We aimed to test the hypothesis that FAPS would show altered visceral sensati...

  10. Quantitative muscle hardness as a noninvasive means for detecting patients at risk of compartment syndromes

    The purpose of this project was to study the efficacy of quantitative muscle hardness (QH) curve analysis for noninvasive measurement of muscle compartment interstitial pressure (IMP), and to eliminate the need for a comparison normal QH measurement to determine a pathologic reading. Elevation of IMP may lead to limb compartment syndrome, which may result in irreversible dysfunction, chronic pain and contracture. Two studies were performed by two separate independent examiners on male volunteers, where IMP measurements and QH curves were obtained. QH curves were divided into three parts comparing the third part to the second part using the coefficient of determination (R2). In 205 limb compartments, there were 1432 comparison readings of the IMP versus R2. Using receiver operator characteristic curve analysis for all data from both studies, an R2 cutoff of 0.974 best corresponded to a pathologic IMP of 50 mmHg. For both sets of data and for each compartment tested, the mean IMP values were statistically different (t-test: P < 0.0001) for the group with R2 values less than 0.974 compared to the group of R2 values greater than or equal to 0.974. In addition, a pressure prediction model was formulated with a strong overall correlation coefficient of 0.78. The data of this study support that QH analysis is potentially useful for the monitoring of IMP elevation in compartment syndrome

  11. MEASUREMENT OF TISSUE PRESSURE, AN AID TO PREDICT COMPARTMENT SYNDROME: OUR STUDY

    Satyanarayana

    2015-10-01

    Full Text Available BACKGROUND : Compartment syndrome ( CS is one of the dreaded complications of fractures. The incidence of CS is more with fractures of tibia and both bones of leg. If not diagnosed early, and treated promptly it may result in much morbidi ty and loss of the limb in extreme cases. So the measurement of tissue pressure in the affected compartment periodically will alert us to the possibility of development of CS. MATERIALS & METHODS : This study was conducted in the Emergency ward , Department of Orthopedics and Traumatology, Gandhi General Hospital , Secunderabad, during the period June 2007 to June 2009. A total of 46 patients were included in the study. The tissue pressures were measured by using an ingenious method, the instrument can be made from commonly available material in the hospital, there by obviating the need for costly equipment . CONCLUSIONS : Measurement of tissue pressure in the affected and normal compartments of the leg in cases of fractures of the leg give us an idea about the impending Compartment Syndrome. The early initiation of appropriate treatment will prevent serious consequences. The measurement of tissue pressure can be done by using a simple instrument .

  12. Noninvasive Monitoring of Elevated Intramuscular Pressure in a Model Compartment Syndrome via Quantitative Fascial Motion

    Lynch, John E.; Lynch, John K; Cole, Steven L.; Carter, Jonathan A.; Hargens, Alan R

    2009-01-01

    Compartment syndromes, caused by elevated intramuscular pressure (IMP) and resulting from trauma or chronic overuse, frequently require invasive IMP monitoring for accurate diagnosis. Our objective is to test a non-invasive ultrasound technique for estimating IMP based on fascial displacement waveforms from arterial blood pressure pulses. In this study, IMP was increased in the legs of 23 healthy adult subjects up to 80 mmHg using two blood pressure cuffs covering the region from the knee to ...

  13. Consequences of Abdominal Adiposity within the Metabolic Syndrome Paradigm in Black People of African Ancestry

    Trudy Gaillard

    2014-01-01

    The metabolic syndrome (MetS) is a constellation of risk factors that are associated with increased risks for coronary heart disease and type 2 diabetes. Although the cause is unknown, abdominal adiposity is considered the underpinning of these metabolic alterations. Hence, increased abdominal adiposity contributes to dyslipidemia, hyperglycemia, beta cell dysfunction, insulin resistance, hypertension and inflammation. The role of abdominal adiposity in the causation of metabolic alterations...

  14. Abdominal pain and syndrome of inappropriate antidiuretic hormone secretion as clinical presentation of acute intermittent porphyria.

    Valle Feijóo, M L; Bermúdez Sanjurjo, J R; González Vázquez, L; Rey Martínez, M; de la Fuente Aguado, J

    2015-01-01

    Acute intermittent porphyria (AIP) is a rare condition characterized by abdominal pain and a wide range of nonspecific symptoms. We report the case of a woman with abdominal pain and syndrome of inappropriate antidiuretic hormone secretion (SIADH) as clinical presentation of AIP. The diagnosis was achieved through the etiologic study of the SIADH. PMID:25796467

  15. Idiopathic abdominal cocoon syndrome with unilateral abdominal cryptorchidism and greater omentum hypoplasia in a young case of small bowel obstruction

    Fei, Xiang; Yang, Hai-Rui; Yu, Peng-Fei; Sheng, Hai-Bo; Gu, Guo-Li

    2016-01-01

    Abdominal cocoon syndrome (ACS) is a rare cause of intestinal obstruction due to total or partial encapsulation of the small intestine by a fibrocollagenous membrane. Idiopathic ACS with abdominal cryptorchidism and greater omentum hypoplasia is even rarer clinically. We successfully treated a 26-year-old male case of small bowel obstruction with acute peritonitis. He was finally diagnosed with idiopathic ACS with unilateral abdominal cryptorchidism and greater omentum hypoplasia during exploratory laparotomy. He then underwent enterolysis, cryptorchidectomy, and appendectomy. He recovered gradually from the operations and early postoperative inflammatory ileus. There has been no recurrence of intestinal obstruction since the operation, and he is still in follow-up. We analyzed his clinical data and retrospectively reviewed the literature, and our findings may be helpful for the clinical diagnosis and treatment on ACS. PMID:27239122

  16. [Preoperative progressive pneumoperitoneum in the treatment of giant abdominal hernias].

    Szekeres, Pál; Krémer, Ildikó; Bukovácz, Róbert; Varga, János

    2007-10-01

    Careful preoperative treatment of giant abdominal hernias can prevent severe postoperative complications such as abdominal compartment syndrome and uncontrollable cardiorespiratory failure. Our departments have been studying the various pathological conditions associated with enormous abdominal hernias (eventration disease) and the possibilities of preventing visceral abnormalities caused by the reconstruction of the abdominal wall. Here, we present the indication, technique and the results of using progressive preoperative pneumo-peritoneum based on two cases. PMID:17984016

  17. Kaposi sarcoma and lymphadenopathy syndrome: limitations of abdominal CT in acquired immunodeficiency syndrome

    Moon, K.L. Jr.; Federle, M.P.; Abrams, D.I.; Volberding, P.; Lewis, B.J.

    1984-02-01

    Abdominal computed tomography (CT) was performed in 31 patients with Kaposi sarcoma (KS) related to acquired immunodeficiency syndrome (AIDS), three patients with classic KS, and 12 patients with the newly described lymphadenopathy syndrome (LNS). The frequency, distribution, and appearance of lymphadenopathy and splenomegaly were similar in the AIDS-related KS and LNS groups. Rectal and perirectal disease was identified in 86% of homosexual men studied; rectal KS could not be distinguished from proctitis on CT criteria alone. No CT abnormalities were seen in patients with classic KS. The CT demonstration of retroperitoneal, mesenteric, or pelvic adenopathy or of rectal or perirectal disease in patients with AIDS-related KS is not necessarily indicative of widespread involvement with the disease.

  18. Kaposi sarcoma and lymphadenopathy syndrome: limitations of abdominal CT in acquired immunodeficiency syndrome

    Abdominal computed tomography (CT) was performed in 31 patients with Kaposi sarcoma (KS) related to acquired immunodeficiency syndrome (AIDS), three patients with classic KS, and 12 patients with the newly described lymphadenopathy syndrome (LNS). The frequency, distribution, and appearance of lymphadenopathy and splenomegaly were similar in the AIDS-related KS and LNS groups. Rectal and perirectal disease was identified in 86% of homosexual men studied; rectal KS could not be distinguished from proctitis on CT criteria alone. No CT abnormalities were seen in patients with classic KS. The CT demonstration of retroperitoneal, mesenteric, or pelvic adenopathy or of rectal or perirectal disease in patients with AIDS-related KS is not necessarily indicative of widespread involvement with the disease

  19. The frequency of abdominal and anorectal surgery in patients with irritable bowel syndrome hospitalized in tertiary center

    KASAP, Elmas; BOR, Serhat; İLTER(), Tankut

    2005-01-01

    Background/aim: It is known that abdominal region operations are more common in patients with irritable bowel syndrome. The aim of this study was to determine the frequency of abdominal region operations in patients with irritable bowel syndrome. Materials and methods: 116 patients hospitalized between January 1998 and December 2002 with irritable bowel syndrome were evaluated retrospectively for previous abdominal region operation. Control group was composed of 53 healthy people and p...

  20. Extravasation of radiographic contrast material and compartment syndrome in the hand: a case report

    Torrededia Laura

    2011-02-01

    Full Text Available Abstract Radiocontrast agents are a type of medical contrast material used to improve the visibility of internal bodily structures in X-ray based imaging techniques such as computed tomography (CT or radiography. Radiocontrast agents are typically iodine or barium compounds. Extravasation of contrast is a possible complication of imaging studies performed with contrasts. Most extravasations cause minimal swelling or erythema, however, skin necrosis, ulceration and compartment syndrome may occur with extravasation of large volumes of contrast. A case report is presented in which significant extravasation of contrast was caused while injecting the contrast intravenously into the back of the hand of a 50 year old patient during computed tomography. The patient was undergoing chemotherapy. The patient developed a compartment syndrome and a fasciotomy was required. Treatment options are outlined and emphasis is made on prevention of this iatrogenic complication. Some of the preventive measures to avoid these complications include use of non-ionic contrast (low osmolarity, careful choice of the site of intravenous administration, and close monitoring of the patient during injection of contrast to minimize or prevent extravasation injuries. Clear information to patients and prompt recognition of the complication can allow for other non-surgical treatment options than the one required in this case.

  1. MRSA toxic shock syndrome associated with surgery for left leg fracture and co-morbid compartment syndrome

    Taro Shimizu; Yufu Yamamoto; Takahiro Hosoi; Kensuke Kinoshita; Yasuharu Tokuda

    2014-01-01

    We report the case of a46-year-oldJapanese man who was brought to the hospital with fever, hypotension and diffuse erythematous rash with multiple organ damage.Three weeks before he had undergone orthopaedic surgery for left leg fracture and comorbid compartment syndrome. Fasciorrhaphy was performed successfully2 weeks before, but the next day he became feverish and hypotensive with signs of systemic low perfusion.He was referred to the hospital for further evaluation and treatment.On arrival, high fever, hypotension and diffuse erythroderma were observed.Lab results revealed multi-organ dysfunction.Clinical manifestations led to the diagnosis of toxic shock syndrome(TSS).The patient was treated with extensive hydration, local drainage and antibiotics.After2 weeks of intensivecare, he recovered and was successfully discharged from the hospital.A culture of the wound tissue revealed the presence ofMRSA with positiveTSST-1.

  2. Anomalies of abdominal organs in polysplenia syndrome: Multidetector computed tomography findings

    Kim, Sung Won; Lee, Yong Seok; Jung, Jin Hee [Dept. of Radiology, Dongguk University Ilsan Hospital, Dongguk University School of Medicine, Goyang (Korea, Republic of)

    2016-02-15

    Polysplenia syndrome is a rare situs ambiguous anomaly associated with multiple spleens and anomalies of abdominal organs. Because most of the minor anomalies do not cause clinical symptoms, polysplenia syndrome is detected incidentally in the adults. Anomalies of abdominal organs may include multiple spleens of variable size or right-sided spleen, large midline or left-sided liver, midline gallbladder, biliary tract anomalies, short pancreas, right-sided stomach, intestinal malrotation, inferior vena cava interruption with azygos or hemiazygos continuation, and a preduodenal portal vein. As the multidetector computed tomography is increasingly used, situs anomalies will likely to be found with greater frequency in the adults. Therefore, radiologists should become familiar with these rare and peculiar anomalies of abdominal organs in polysplenia syndrome.

  3. Comparison of the relative contributions of intra-abdominal and liver fat to components of the metabolic syndrome

    Kotronen, Anna; Yki-Järvinen, Hannele; Sevastianova, Ksenia; Bergholm, Robert; Hakkarainen, Antti; Pietiläinen, Kirsi H; Juurinen, Leena; Lundbom, Nina; Sørensen, Thorkild I A

    2011-01-01

    Abdominally obese individuals with the metabolic syndrome often have excess fat deposition both intra-abdominally (IA) and in the liver, but the relative contribution of these two deposits to variation in components of the metabolic syndrome remains unclear. We determined the mutually independent...

  4. Collateral abdominal circulation in patient with Leriche's syndrome diagnosed with 64-row multislice computed tomography (MSCT)

    Leriche's syndrome results from slowly developing occlusion of the abdominal aorta. It affects mainly middle-aged males. The blood flow distal to the occlusion site is secured by collateral circulation. Signs of Leriche's syndrome include claudication, gluteal pain and impotence. The paper presents a patient with Leriche's syndrome, in whom a detailed visualization of collateral circulation was obtained with multislice computed tomography angiography. Patient underwent surgical recanalization of the aorta with an excellent result. To our knowledge, the presented case is the first description of collateral circulation in Leriche's syndrome obtained with 64-row computed tomography. (author)

  5. A prospective blinded evaluation of exercise thallium-201 SPET in patients with suspected chronic exertional compartment syndrome of the leg

    This study compared the quantitative and qualitative results of leg thallium-201 single-photon emission tomography (SPET) imaging in patients with and without raised intracompartmental pressure associated with exercise-related leg pain. The purpose of this study was to clarify the aetiology of chronic exertional compartment syndrome (CECS), and to investigate the diagnostic applications of 201Tl SPET in CECS. Thirty-four study participants underwent compartment pressure testing (CPT) between March and August 2000. There were 25 positive CPT results (patient group), and nine negative CPT results (control group). All 34 participants underwent scintigraphy. Quantitative and qualitative assessments were performed for the anterolateral and deep posterior compartments of the lower leg. There was no significant difference in either quantitative or qualitative assessments of perfusion between those compartments with and those without CECS. In contrast, a marked effect of exercise type upon compartment perfusion pattern was noted. Results of this study indicate that there is no compartment perfusion deficit in those patients with raised intracompartmental pressure associated with CECS, and suggest a non-ischaemic basis for the pain associated with CECS. They also suggest no role for exercise perfusion scintigraphy in the diagnosis of this syndrome. (orig.)

  6. Abdominal Computed tomography of 25 patients with AIDS or lymphadenopathy Syndrome

    Arrive, L.; Frija, J.; Couderc, L.J.; Clauvel, J.P.; Laval-Jeantet, M.

    1986-03-01

    An abdominal computed tomographic examination was performed to 20 patients with Acquired Immunodeficiency Syndrome (AIDS) and to 5 patients with Lymphadenopathy Syndrome (LAS). Intraabdominal lymph nodes were seen in 18 out of 20 cases of AIDS and in 5 cases of LAS. Lymph nodes have a normal size or are slightly enlarged but they are too numerous. Splenomegaly was found in 17 patients. Rectal modifications secondary to a proctitis were seen in the homosexual patients.

  7. Abdominal Computed tomography of 25 patients with AIDS or lymphadenopathy Syndrome

    An abdominal computed tomographic examination was performed to 20 patients with Acquired Immunodeficiency Syndrome (AIDS) and to 5 patients with Lymphadenopathy Syndrome (LAS). Intraabdominal lymph nodes were seen in 18 out of 20 cases of AIDS and in 5 cases of LAS. Lymph nodes have a normal size or are slightly enlarged but they are too numerous. Splenomegaly was found in 17 patients. Rectal modifications secondary to a proctitis were seen in the homosexual patients

  8. Upper gastrointestinal obstruction secondary to aortoduodenal syndrome owing to a noninflammatory abdominal aortic aneurysm.

    Cahill, Kevin

    2012-01-31

    Aortoduodenal syndrome is a rare complication of an abdominal aortic aneurysm wherein the aneurysm sac obstructs the patient\\'s duodenum. It presents with the symptoms of an upper gastrointestinal tract obstruction and requires surgical intervention to relieve it. Previously, gastric bypass surgery was advocated, but now aortic replacement is the mainstay of treatment. We report a case of a 67-year-old woman whose aortoduodenal syndrome was successfully managed and review the literature on this topic.

  9. Compartment syndrome of the lower leg after surgery in the modified lithotomy position : Report of seven cases

    Wassenaar, Eelco B.; van den Brand, Johan G. H.; van der Werken, Christian

    2006-01-01

    PURPOSE: Acute compartment syndrome is known to develop after trauma or after postischemic revascularization. It also can occur when a patient has been lying in the lithotomy position during prolonged surgery. Methods were searched for the prevention of this iatrogenic complication after a series of

  10. Ankle fusion with a retrograde locked intramedullary nail for sequela of lower extremity compartment syndrome

    WANG Xu; MA Xin; ZHANG Chao; HUANG Jia-zhang; GU Xiang-jie; JIANG Jian-yuan

    2012-01-01

    Objective: To assess the value of ankle fusion with a retrograde locked intramedullary nail in the treatment of sequela of lower extremity compartment syndrome.Methods:Thirty-five cases of equinus deformity following tibiofibular compartment syndrome treated by means of ankle fusion with a retrograde locked intramedullary nail from January 2001 to December 2010 were retrospectively reviewed.The complications,the time needed for bony fusion of the ankle joint assessed by anteroposterior and lateral X-ray photographs as well as patients' subjective evaluation were recorded and analysed.Results: Among the 35 patients,15 had previously undergone surgical treatment twice on the same limb,13 had thrice and 7 had to be operated on four times before ankle fusion.An anterior midpoint approach to the ankle joint was adopted in 29 cases,while anterior midpoint approach plus a small incision on the posterior ankle joint was made in 17 cases,whereas lateral approach in 6 cases.Tarsus joint fusion was performed on 4 cases.The follow-up period ranged 6-124 months,averaged 40.6 months.Bone grafting was not performed in this series.Preoperative tibial shaft fracture occurred in one patient and was healed after conservative treatment.Incision dehiscence located at previous Achilles tendon incision was found in two patients.As a result,one received an intramedullary nail emplacement at calcaneoplantar part while the wound at anterosuperior part of the other one was healed by dressing change.Two patients failed to bony union 5 months postoperatively,in which one healed 10 weeks after retrieval of proximal tibial nail and another by iliac grafting.Terminal necrosis of the toe due to blood supply dysfunction was not found in this series.All the patients were satisfied with the ankle joint function postoperatively.The time for bony union on X-rays was 9.8 weeks on average.Except for one patient who demanded removal of intramedullary nail,all the intramedullary nails were not retrieved at

  11. Risk factors of gastroparesis syndrome after abdominal non-gastroduodenal operation and its prevention

    Dong-Dong Yang; Kun He; Xue-Liang Wu; Li-Kun Yang; Shuang-Fa Nie

    2013-01-01

    Objective: To investigate risk factors of gastroparesis syndrome (PGS) after abdominal non-gastroduodenal operation and its prevention. Methods: Clinical data of 22 patients with PGS after abdominal non-gastroduodenal operation was analyzed retrospectively, and compared with the patients of non-PGS after abdominal non-gastroduodenal operation during the same time. The possible influencing factors of PGS were analyzed by single factor analysis and logistic regression analysis.Results: All 13 selected factors related with PGS, including age, disease category (benign and malignant), operation time, intraoperative blood loss, postoperative analgesic pump, postoperative enteral nutrition time, postoperative parenteral nutrition time, perioperative blood glucose level, perioperative nutrition status (anaemia or lower proteinemia), pylorus obstruction before surgery, intra-abdominal infection after surgery, and spiritual factor were related with PGS. The statistical analysis showed that the difference was statistical significant (P0.05); non-conditional multivariate analysis showed that malignant tumor, perioperative nutrition status, pylorus obstruction, operation time, blood loss, intra-abdominal infection after surgery, and mental factor were significant related with PGS as dependent variable and related risk factors in single factor analysis as independent variables (P <0.05). Conclusions: PGS is a result of multiple factors, and among these factors, malignant tumor, poor nutrition status, pylorus obstruction before surgery, longer operation-time, more blood loss, intra-abdominal infection after surgery, and mental factor are major risk factors of PGS.

  12. A rare cause of acute abdominal pain: Herlyn-Werner-Wunderlich syndrome.

    Aydin, Ramazan; Ozdemir, Ayse Zehra; Ozturk, Bahadir; Bilgici, Meltem Ceyhan; Tosun, Migraci

    2014-01-01

    Herlyn-Werner-Wunderlich (HWW) syndrome is a rare müllerian duct anomaly with uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. Patients with this syndrome generally present after menarche with pelvic pain and mass and, rarely, primary infertility in later years. Strong suspicion and knowledge of this syndrome are mandatory for an accurate diagnosis. A 14-year-old female patient presented with acute retention of urine and abdominopelvic pain. Her condition was diagnosed with the use ultrasonography and magnetic resonance imaging as a case of HWW syndrome. She was treated with vaginal hemiseptal resection. The HWW syndrome should be considered among the differential diagnoses in girls with renal anomalies presenting with pelvic mass, symptoms of acute abdominal pain, and acute urinary retention. PMID:24378860

  13. Value of abdominal angiography in Turner's syndrome

    Barreto, A.; Castaneda-Zuniga, W.R.; Velasquez, G.; Zollikofer, C.; Amplatz, K.

    1981-01-01

    In patients with Turner's syndrome, there is a relatively high incidence of gastrointestinal bleeding due to telangiectasias of the intestine. Despite the importance of preoperative diagnosis of the lesion in planning surgical treatment. The related angiographic findings have never been reported. We have studied one patient in whom the diagnosis was established by preoperative angiography.

  14. The value of abdominal angiography in Turner's syndrome

    In patients with Turner's syndrome, there is a relatively high incidence of gastrointestinal bleeding due to telangiectasias of the intestine. Despite the importance of preoperative diagnosis of the lesion in planning surgical treatment. The related angiographic findings have never been reported. We have studied one patient in whom the diagnosis was established by preoperative angiography. (orig.)

  15. Microwave tomography of extremities: 2. Functional fused imaging of flow reduction and simulated compartment syndrome

    Semenov, Serguei; Kellam, James; Nair, Bindu; Williams, Thomas; Quinn, Michael; Sizov, Yuri; Nazarov, Alexei; Pavlovsky, Andrey

    2011-04-01

    Medical imaging has recently expanded into the dual- or multi-modality fusion of anatomical and functional imaging modalities. This significantly improves the diagnostic power while simultaneously increasing the cost of already expensive medical devices or investigations and decreasing their mobility. We are introducing a novel imaging concept of four-dimensional (4D) microwave tomographic (MWT) functional imaging: three dimensional (3D) in the spatial domain plus one dimensional (1D) in the time, functional dynamic domain. Instead of a fusion of images obtained by different imaging modalities, 4D MWT fuses absolute anatomical images with dynamic, differential images of the same imaging technology. The approach was successively validated in animal experiments with short-term arterial flow reduction and a simulated compartment syndrome in an initial simplified experimental setting using a dedicated MWT system. The presented fused images are not perfect as MWT is a novel imaging modality at its early stage of the development and ways of reading reconstructed MWT images need to be further studied and understood. However, the reconstructed fused images present clear evidence that microwave tomography is an emerging imaging modality with great potentials for functional imaging.

  16. Compartment syndrome as a complication of ileofemoral deep venous thrombosis:a case presentation.

    Lamborn, David R; Schranz, Craig

    2014-02-01

    A 22-year-old morbidly obese, nonpregnant woman presented with left ileofemoral deep vein thrombosis (DVT) presenting as low back pain and bilateral, left greater than right, leg swelling and pain for 2 days. While on heparin, she developed compartment syndrome in her left leg and had evidence of dead muscle tissue at the time of fasciotomy. Three options exist for treatment of ileofemoral DVT: catheter-directed thrombolysis (CDT), CDT plus pharmacomechanical thrombolysis or percutaneous mechanical thrombectomy, and surgical thrombectomy. Catheter-directed thrombolysis alone or in conjunction with pharmacomechanical thrombolysis in patients with low risk of bleeding has shown significant lysis of occlusion in 79% of patients with ileofemoral DVT with relatively low complication rates. Surgical thrombectomy and fasciotomy have not proven to be as effective but are appropriate alternatives if CDT is not available. Standard anticoagulation alone is likely not a sufficient treatment for ileofemoral DVT. Other therapies including CDT, CDT plus pharmacomechanical thrombolysis or percutaneous mechanical thrombectomy, or surgical thrombectomy to address lysis of the clot should be attempted first or in conjunction with anticoagulation for appropriate patients. Catheter-directed thrombolysis with or without pharmacomechanical thrombolysis is the preferred initial treatment. PMID:24091199

  17. Well leg compartment syndrome after surgery for ulcerative colitis in the lithotomy position: A case report

    Enomoto, Tsuyoshi; Ohara, Yusuke; Yamamoto, Masayoshi; Oda, Tatsuya; Ohkohchi, Nobuhiro

    2016-01-01

    Introduction Well leg compartment syndrome (WLCS) is an uncommon and severe complication that occurs after colorectal surgery in the lithotomy position. Presentation of case The current patient was a 28-year-old male suffering from ulcerative colitis. He was underwent elective proctectomy, including ileal J pouch formation and anal anastomosis with temporary loop ileostomy. The ileoanal pouch procedure was quite difficult, and during this procedure, the high lithotomy and head down tilt positions were continued for 255 min. After the operation, the patient complained of severe cramping pain, swelling and serious tenderness on palpation in both legs. On the first postoperative day, the patient's complaints gradually worsened. The intra-compartmental pressure was measured, and WLCS was diagnosed. Emergency bilateral fasciotomy was performed. Initially, the patient had a sensory deficit and analgesia, however, his sensory disturbance and pain had almost recovered two months after fasciotomy by rehabilitation. Discussion In the current case, the important factors associated with the development of WLCS are thought to be a prolonged operative time in which the patient is placed in the high lithotomy position during ileoanal pouch procedure. Conclusion We would thus like to emphasize that operations for the ileoanal pouch procedure to treat ulcerative colitis have a high potential for inducing WLCS, because it usually requires a prolonged operative time in which the patient remains in the high lithotomy position. PMID:27085103

  18. Microwave tomography of extremities: 2. Functional fused imaging of flow reduction and simulated compartment syndrome

    Semenov, Serguei; Nair, Bindu [School of Medicine, ISTM, Keele University, Stoke-on-Trent, ST4 7QB (United Kingdom); Kellam, James; Williams, Thomas; Quinn, Michael [Carolinas Medical Center, Charlotte, NC 28203 (United States); Sizov, Yuri [TRINITI, Moscow Region (Russian Federation); Nazarov, Alexei [INTEGRIT, Moscow (Russian Federation); Pavlovsky, Andrey, E-mail: s.semenov@pmed.keele.ac.uk [DIGIMEQ, Moscow (Russian Federation)

    2011-04-07

    Medical imaging has recently expanded into the dual- or multi-modality fusion of anatomical and functional imaging modalities. This significantly improves the diagnostic power while simultaneously increasing the cost of already expensive medical devices or investigations and decreasing their mobility. We are introducing a novel imaging concept of four-dimensional (4D) microwave tomographic (MWT) functional imaging: three dimensional (3D) in the spatial domain plus one dimensional (1D) in the time, functional dynamic domain. Instead of a fusion of images obtained by different imaging modalities, 4D MWT fuses absolute anatomical images with dynamic, differential images of the same imaging technology. The approach was successively validated in animal experiments with short-term arterial flow reduction and a simulated compartment syndrome in an initial simplified experimental setting using a dedicated MWT system. The presented fused images are not perfect as MWT is a novel imaging modality at its early stage of the development and ways of reading reconstructed MWT images need to be further studied and understood. However, the reconstructed fused images present clear evidence that microwave tomography is an emerging imaging modality with great potentials for functional imaging.

  19. Microwave tomography of extremities: 2) Functional fused imaging of flow reduction and simulated compartment syndrome

    Semenov, Serguei; Kellam, James; Nair, Bindu; Williams, Thomas; Quinn, Michael; Sizov, Yuri; Nazarov, Alexei; Pavlovsky, Andrey

    2011-01-01

    Medical imaging has recently expanded into the dual- or multi-modality fusion of anatomical and functional imaging modalities. This significantly improves the diagnostic power while simultaneously increasing the cost of an already expensive medical devices or investigations and decreasing their mobility. We are introducing a novel imaging concept of four-dimensional (4D) Microwave Tomographic (MWT) functional imaging: three-dimensional (3D) in spatial domain plus one-dimension (1D) in the time, functional dynamic domain. Instead of a fusion of images obtained by different imaging modalities, 4D MWT fuses absolute anatomical images with dynamic, differential images of the same imaging technology. The approach was successively validated in animal experiments with short term arterial flow reduction and a simulated compartment syndrome in an initial simplified experimental setting using dedicated microwave tomographic system. The presented fused images are not perfect as MWT is a novel imaging modality at its early stage of the development and ways of reading of reconstructed MWT images need to be further studied and understood. However, the reconstructed fused images present clear evidence that microwave tomography is an emerging imaging modality with great potentials for functional imaging. PMID:21364266

  20. Microwave tomography of extremities: 2. Functional fused imaging of flow reduction and simulated compartment syndrome

    Medical imaging has recently expanded into the dual- or multi-modality fusion of anatomical and functional imaging modalities. This significantly improves the diagnostic power while simultaneously increasing the cost of already expensive medical devices or investigations and decreasing their mobility. We are introducing a novel imaging concept of four-dimensional (4D) microwave tomographic (MWT) functional imaging: three dimensional (3D) in the spatial domain plus one dimensional (1D) in the time, functional dynamic domain. Instead of a fusion of images obtained by different imaging modalities, 4D MWT fuses absolute anatomical images with dynamic, differential images of the same imaging technology. The approach was successively validated in animal experiments with short-term arterial flow reduction and a simulated compartment syndrome in an initial simplified experimental setting using a dedicated MWT system. The presented fused images are not perfect as MWT is a novel imaging modality at its early stage of the development and ways of reading reconstructed MWT images need to be further studied and understood. However, the reconstructed fused images present clear evidence that microwave tomography is an emerging imaging modality with great potentials for functional imaging.

  1. Microwave tomography of extremities: 2. Functional fused imaging of flow reduction and simulated compartment syndrome.

    Semenov, Serguei; Kellam, James; Nair, Bindu; Williams, Thomas; Quinn, Michael; Sizov, Yuri; Nazarov, Alexei; Pavlovsky, Andrey

    2011-04-01

    Medical imaging has recently expanded into the dual- or multi-modality fusion of anatomical and functional imaging modalities. This significantly improves the diagnostic power while simultaneously increasing the cost of already expensive medical devices or investigations and decreasing their mobility. We are introducing a novel imaging concept of four-dimensional (4D) microwave tomographic (MWT) functional imaging: three dimensional (3D) in the spatial domain plus one dimensional (1D) in the time, functional dynamic domain. Instead of a fusion of images obtained by different imaging modalities, 4D MWT fuses absolute anatomical images with dynamic, differential images of the same imaging technology. The approach was successively validated in animal experiments with short-term arterial flow reduction and a simulated compartment syndrome in an initial simplified experimental setting using a dedicated MWT system. The presented fused images are not perfect as MWT is a novel imaging modality at its early stage of the development and ways of reading reconstructed MWT images need to be further studied and understood. However, the reconstructed fused images present clear evidence that microwave tomography is an emerging imaging modality with great potentials for functional imaging. PMID:21364266

  2. Acute abdominal pain in a man with Cushing syndrome.

    Rahmanian, M; Nedooshan, J J; Rafat, S; Rafie, R; Rafiei, M; Moghadam, R N

    2015-10-01

    Arterial thrombosis or emboli have rarely been reported in Cushing syndrome (CS). Here we describe the first case of mesenteric ischaemia secondary to ventricular emboli in a patient with CS. Laboratory evaluation showed increased fibrinogen and factor VIII. Previous studies showed that venous thromboembolism (VTE) increases in CS. This case for the first time described arterial system thrombosis and emboli in a patient with adrenocorticotropin (ACTH)-dependent CS. PMID:25943108

  3. Clinical Observation on the Effects of Bo's Abdominal Acupuncture in 40 Cases of Chronic Fatigue Syndrome

    HUANG Yong; LIAO Xiao-ming; LI xiao-xi; SONG Yuan-bin

    2008-01-01

    objective;To observe the curative effect of Bo's abdominal acupuncture on chronic fatigue syndrome(CFS).Methods;Forty cases with CFS were treated by Bo's abdominal acupuncture at me points for conducting qi back to its origin and 4 points on the abdomen once a dav for 2 weeks.Scores for symptoms and scores for fatigue questionnaires were compared before and after treatment.Results;After treatment,the clinical symptoms of patients were differently alleviated,and scores for symptoms,mental condition and neural feeling in questionnaires on fatigue were obviously reduced(P<0.01-0.05).Conclusion;Bo's abdominal acupuncture has a good curative effect on general disease with complex symptoms,especially on lassitude,anorlexia,insomnia,amnesia,diarrhea,and general pain.

  4. The Effectiveness of a 6-Week Intervention Program Aimed at Modifying Running Style in Patients With Chronic Exertional Compartment Syndrome

    Helmhout, Pieter H.; Diebal, Angela R.; van der Kaaden, Lisanne; Harts, Chris C.; Beutler, Anthony; Zimmermann, Wes O.

    2015-01-01

    Background: Previous studies have reported on the promising effects of changing running style in patients with chronic exertional compartment syndrome (CECS) using a 6-week training program aimed at adopting a forefoot strike technique. This study expands that work by comparing a 6-week in-house, center-based run training program with a less extensive, supervised, home-based run training program (50% home training). Hypothesis: An alteration in running technique will lead to improvements in C...

  5. Abdominal obesity and the metabolic syndrome: A surgeon’s perspective

    Mathieu, Patrick

    2008-01-01

    Over the past decade, a major shift in the clinical risk factors in the population undergoing a cardiac surgery has been observed. In the general population, an increasing prevalence of obesity has largely contributed to the development of cardiovascular disorders. Obesity is a heterogeneous condition in which body fat distribution largely determines metabolic perturbations. Consequently, individuals characterized by increased abdominal fat deposition and the so-called metabolic syndrome (Met...

  6. Effect of Ventilatory Support on Abdominal Fluid Balance in a Sepsis Model

    Lattuada, Marco

    2013-01-01

    In patients affected by acute respiratory failure or acute respiratory distress syndrome (ARDS) the leading cause of death is failure of different vital organs other than the lungs, so called multiple organ dysfunction syndrome (MODS). The abdominal organs have a crucial role in the pathogenesis of this syndrome. There is a lack of knowledge regarding the mechanisms by which mechanical ventilation can affect the abdominal compartment. One hypothesis is that mechanical ventilation can interfer...

  7. Acute Compartment Syndrome of the Arm after Minor Trauma in a Patient with Optimal Range of Oral Anticoagulant Therapy: A Case Report

    Paolo Titolo; Patrizia Milani; Bernardino Panero; Davide Ciclamini; Giulia Colzani; Stefano Artiaco

    2014-01-01

    Compartment syndrome of the arm is a rare event that can be subsequent to trauma or other pathological and physical conditions. At the arm the thin and elastic fascia may allow accumulation of blood more than in other districts, especially in patients undergoing anticoagulant therapy. We describe a rare case of an acute compartment syndrome of the arm after minor trauma with partial biceps brachii rupture in a patient with warfarin therapy and optimal value of INR. Prompt diagnosis and sur...

  8. Compartment syndrome of thigh and lower leg with disruption of the popliteal vascular bundle after being run over by a 25-ton truck

    Burghardt Rolf D

    2013-10-01

    Full Text Available 【Abstract】Compartment syndrome of the thigh is a rare condition, potentially resulting in devastating functional outcome. Increasing intracompartmental pressure which suppresses microcirculation and capillary perfusion may lead to cellular anoxia and muscle ischemia. The muscle compartments in the thigh have a more compliant fascia and blend anatomically into the open compartments of the pelvis, thus compensating higher volumes than the compartments in the lower leg. We present a previously unreported case in which the limb of a 36-year-old man was run over by a 25-ton truck. He presented with a sensomotor deficit in his left lower leg with full paralysis of the shank muscles and absence of all foot pulses. CT scan showed a huge haematoma in the thigh with active bleeding out of the popliteal artery into the haematoma which has already expanded into the muscle compartments of the lower leg. The limb had a disastrous compartment syndrome of the thigh and lower leg with disruption of the popliteal neurovascular bundle; however, no bones in the limb were fractured. A complete fasciotomy of all the lower limb muscle compartments was immediately performed. The artery was reconstructed with interposition of the smaller saphenous vein, which was already interrupted through the initial trauma. Key words: Compartment syndromes; Thigh; Hemorrhage; Popliteal artery; Peroneal nerve

  9. A case report of thoracic compartment syndrome in the setting of penetrating chest trauma and review of the literature

    An Gary C

    2010-07-01

    Full Text Available Abstract Trauma-related thoracic compartment syndrome (TCS is a rare, life threatening condition that develops secondary to elevated intra-thoracic pressure and manifests itself clinically as significantly elevated airway pressures, inability to provide adequate ventilation and hemodynamic instability temporally related to closure of a thoracic surgical incision. TCS is exceedingly rare in the trauma population. We present a case of TCS following surgical repair of a stab wound injury that necessitated decompressive thoracotomy and peri-operative open-chest management.

  10. Intra-abdominal fat is related to metabolic syndrome and non-alcoholic fat liver disease in obese youth

    Silveira, Loreana Sanches; Monteiro, Paula Alves; Antunes, Bárbara de Moura Mello; Seraphim, Patrícia Monteiro; Fernandes, Rômulo Araújo; Christofaro, Diego G Destro; Júnior, Ismael F Freitas

    2013-01-01

    Background Previous studies have shown an association between adiposity, especially intra-abdominal adipose tissue, and hemodynamic/metabolic comorbidities in adults, however it is not clear in pediatric population. The aim of the study was to analyze the relationship between non-alcoholic fatty liver disease (NAFLD) and components of metabolic syndrome (MS) with values of intra-abdominal (IAAT) and subcutaneous (SCAT) adipose tissue in obese children and adolescents. Methods Cross-sectional ...

  11. A Case of Ischemic Duodenitis Associated with Superior Mesenteric Artery Syndrome Caused by an Abdominal Aortic Aneurysm

    OKUYAMA, Yusuke; Kawakami, Takumi; Ito, Haruki; Otsuka, Hirotomo; Enoki, Yasuyuki; Nishimura, Masahito; Yoshida, Norimasa; Fujimoto, Sotaro

    2011-01-01

    A 74-year-old woman was admitted to our hospital with upper abdominal pain and bloody vomiting. An abdominal aneurysm compressed the third portion of the duodenum and the second portion of duodenum was distended with thickened walls as in superior mesenteric artery syndrome. Endoscopic examination showed an edematous mucosa with hemorrhagic erosions, shallow longitudinal ulcers, and star-shaped ulcers in the duodenum. We diagnosed this case as ischemic duodenitis associated with superior mese...

  12. Intra-Abdominal Testicular Seminoma in a Woman with Testicular Feminization Syndrome

    Darshana D. Rasalkar

    2011-01-01

    Full Text Available We report a case of intra-abdominal testicular tumor in a 36-year-old married lady presenting with chief complaints of primary amenorrhea. The patient was later diagnosed with testicular feminization syndrome, a form of male pseudohermaphroditism. This testicular tumor was histologically proven as seminoma. Due to rarity, imaging findings in patients with testicular feminization syndrome and intraabdominal testicular tumor have been poorly documented. So far, only one case report had described the combined role of CT and MR imaging in intraabdominal testicular sex-cord stromal tumor. To our knowledge, this case is first to document USG and MR imaging in addition to MR spectroscopy features in intraabdominal testicular seminoma.

  13. Near-infrared spectroscopy for monitoring of tissue oxygenation of exercising skeletal muscle in a chronic compartment syndrome model

    Breit, G. A.; Gross, J. H.; Watenpaugh, D. E.; Chance, B.; Hargens, A. R.

    1997-01-01

    Variations in the levels of muscle hemoglobin and of myoglobin oxygen saturation can be detected non-invasively with near-infrared spectroscopy. This technique could be applied to the diagnosis of chronic compartment syndrome, in which invasive testing has shown increased intramuscular pressure associated with ischemia and pain during exercise. We simulated chronic compartment syndrome in ten healthy subjects (seven men and three women) by applying external compression, through a wide inflatable cuff, to increase the intramuscular pressure in the anterior compartment of the leg. The tissue oxygenation of the tibialis anterior muscle was measured with near-infrared spectroscopy during gradual inflation of the cuff to a pressure of forty millimeters of mercury (5.33 kilopascals) during fourteen minutes of cyclic isokinetic dorsiflexion and plantar flexion of the ankle. The subjects exercised with and without external compression. The data on tissue oxygenation for each subject then were normalized to a scale of 100 per cent (the baseline value, or the value at rest) to 0 per cent (the physiological minimum, or the level of oxygenation achieved by exercise to exhaustion during arterial occlusion of the lower extremity). With external compression, tissue oxygenation declined at a rate of 1.4 +/- 0.3 per cent per minute (mean and standard error) during exercise. After an initial decrease at the onset, tissue oxygenation did not decline during exercise without compression. The recovery of tissue oxygenation after exercise was twice as slow with compression (2.5 +/- 0.6 minutes) than it was without the use of compression (1.3 +/- 0.2 minutes).

  14. Altered rectal sensory response induced by balloon distention in patients with functional abdominal pain syndrome

    Kudaira Miwako

    2009-11-01

    Full Text Available Abstract Background Functional abdominal pain syndrome (FAPS has chronic unexplained abdominal pain and is similar to the psychiatric diagnosis of somatoform pain disorder. A patient with irritable bowel syndrome (IBS also has chronic unexplained abdominal pain, and rectal hypersensitivity is observed in a majority of the patients. However, no reports have evaluated the visceral sensory function of FAPS precisely. We aimed to test the hypothesis that FAPS would show altered visceral sensation compared to healthy controls or IBS. The present study determined the rectal perceptual threshold, intensity of sensation using visual analogue scale (VAS, and rectal compliance in response to rectal balloon distention by a barostat in FAPS, IBS, and healthy controls. Methods First, the ramp distention of 40 ml/min was induced and the thresholds of discomfort, pain, and maximum tolerance (mmHg were measured. Next, three phasic distentions (60-sec duration separated by 30-sec intervals of 10, 15 and 20 mmHg were randomly loaded. The subjects were asked to mark the VAS in reference to subjective intensity of sensation immediately after each distention. A pressure-volume relationship was determined by plotting corresponding pressures and volumes during ramp distention, and the compliance was calculated over the linear part of the curve by calculating from the slope of the curve using simple regression. Results Rectal thresholds were significantly reduced in IBS but not in FAPS. The VAS ratings of intensity induced by phasic distention (around the discomfort threshold of the controls were increased in IBS but significantly decreased in FAPS. Rectal compliance was reduced in IBS but not in FAPS. Conclusion An inconsistency of visceral sensitivity between lower and higher pressure distention might be a key feature for understanding the pathogenesis of FAPS.

  15. A migraine variant with abdominal colic and Alice in wonderland syndrome: a case report and review

    Hamed Sherifa A

    2010-01-01

    Full Text Available Abstract Background Abdominal migraine is a commonly described migraine variant in children and young adults, but associations with Alice in Wonderland syndrome and lilliputian hallucinations are exceptional. Case presentation A 20 years-old male experienced frequent and prolonged attacks of abdominal colic associated with autonomic manifestations started at the age of ten. At the age of 17, he additionally described prolonged attacks (≥ 7 days of distortions of shape, size or position of objects or subjects. He said "Quite suddenly, objects appear small and distant (teliopsia or large and close (peliopsia. I feel as I am getting shorter and smaller "shrinking" and also the size of persons are not longer than my index finger (a lilliputian proportion. Sometimes I see the blind in the window or the television getting up and down, or my leg or arm is swinging. I may hear the voices of people quite loud and close or faint and far. Occasionally, I experience attacks of migrainous headache associated with eye redness, flashes of lights and a feeling of giddiness. I am always conscious to the intangible changes in myself and my environment". There is a strong family history of common migraine. Clinical examination, brain-MRI and EEG were normal. Transcranial magnetic stimulation and evoked potentials revealed enhanced cortical excitability in multiple brain regions. Treatment with valproate resulted in marked improvement of all clinical and neurophysiological abnormalities. Conclusions The association between the two migraine variants (abdominal migraine and Alice in Wonderland Syndrome might have clinical, pathophysiological and management implications. I think this is the first description in the literature.

  16. Diagnosis and Treatment of Chronic Exertional Compartment Syndrome - a Proposition for an Algorithm

    Larsen, Peter Birk; Jensen, Steffen Skov

    patients seen in the period from Nov 2011 to May 2014 (6 women and 7 men, mean age 26 years, range 15-46 years). We used an algorithm of MRI scan or bone scintegraphy to rule out other pathology. Subsequently the patient was examined by a physiotherapist and exposed to SAIS. The objective findings...... additional EASF of other compartments than primarily diagnosed. At three months follow up 82% of the patients had regained their physical capabilities as prior to the condition. Conclusions: Diagnosing CECS using an algorihm consisting of physiotherapist examination including SAIS allows the surgeon...

  17. Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine

    Andréia Mitidieri

    2015-12-01

    Full Text Available Objectives: This study used semiology based on traditional Chinese medicine (TCM to investigate vital energy (Qi behavior in women with abdominal myofascial pain syndrome (AMPS. Methods: Fifty women diagnosed with chronic pelvic pain (CPP secondary to AMPS were evaluated by using a questionnaire based on the theories of “yin-yang,” “zang-fu”, and “five elements”. We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs; onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine, menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%, possessed a elementary school (66%, and had one or two children (76%. The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 — 39.0 and 32.4% (range: 10.7 — 45.7, respectively. A large majority of women (96% exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the

  18. Perivascular adipose tissue: An unique fat compartment relevant for the cardiometabolic syndrome.

    Siegel-Axel, D I; Häring, H U

    2016-03-01

    Type 2 diabetes and its major risk factor, obesity, are an increasing worldwide health problem. The exact mechanisms that link obesity with insulin resistance, type 2 diabetes, hypertension, cardiovascular complications and renal diseases, are still not clarified sufficiently. Adipose tissue in general is an active endocrine and paracrine organ that may influence the development of these disorders. Excessive body fat in general obesity may also cause quantitative and functional alterations of specific adipose tissue compartments. Beside visceral and subcutaneous fat depots which exert systemic effects by the release of adipokines, cytokines and hormones, there are also locally acting fat depots such as peri- and epicardial fat, perivascular fat, and renal sinus fat. Perivascular adipose tissue is in close contact with the adventitia of large, medium and small diameter arteries, possesses unique features differing from other fat depots and may act also independently of general obesity. An increasing number of studies are dealing with the "good" or "bad" characteristics and functions of normally sized and dramatically increased perivascular fat mass in lean or heavily obese individuals. This review describes the origin of perivascular adipose tissue, its different locations, the dual role of a physiological and unphysiological fat mass and its impact on diabetes, cardiovascular and renal diseases. Clinical studies, new imaging methods, as well as basic research in cell culture experiments in the last decade helped to elucidate the various aspects of the unique fat compartment. PMID:26995737

  19. SURGICAL MANAGEMENT OF A RARE CASE OF MARFAN SYNDROME - THE RUPTURE OF AN ABDOMINAL AORTIC ANEURYSM

    L. Stoica

    2005-10-01

    Full Text Available We present a rare manifestation of the Marfan syndrome. A 33 years old woman with a 10 cm diameter juxta-renal aortic aneurysm ruptured in the retro peritoneum arrived in hemorrhagic shock. Surgery was performed in emergency by thoraco-phreno-laparatomy, the aneurysm was resected and a 20 mm Dacron tube was sutured between the origin of the renal arteries and the aortic bifurcation. Rapid thoracic aortic cross-clamping to stop the hemorrhage and good aneurismal exposure by the division of the left renal vein was the key of this successful management. The patient recovered without any complication. Rupture of the abdominal aortic aneurysm is a life threatening complication which requires a rapid diagnosis and an emergency treatment by open surgery or by endovascular stent grafting. We present the surgical strategy in our case

  20. Abdominal Muscle Activity during Mechanical Ventilation Increases Lung Injury in Severe Acute Respiratory Distress Syndrome.

    Xianming Zhang

    Full Text Available It has proved that muscle paralysis was more protective for injured lung in severe acute respiratory distress syndrome (ARDS, but the precise mechanism is not clear. The purpose of this study was to test the hypothesis that abdominal muscle activity during mechanically ventilation increases lung injury in severe ARDS.Eighteen male Beagles were studied under mechanical ventilation with anesthesia. Severe ARDS was induced by repetitive oleic acid infusion. After lung injury, Beagles were randomly assigned into spontaneous breathing group (BIPAPSB and abdominal muscle paralysis group (BIPAPAP. All groups were ventilated with BIPAP model for 8h, and the high pressure titrated to reached a tidal volume of 6ml/kg, the low pressure was set at 10 cmH2O, with I:E ratio 1:1, and respiratory rate adjusted to a PaCO2 of 35-60 mmHg. Six Beagles without ventilator support comprised the control group. Respiratory variables, end-expiratory volume (EELV and gas exchange were assessed during mechanical ventilation. The levels of Interleukin (IL-6, IL-8 in lung tissue and plasma were measured by qRT-PCR and ELISA respectively. Lung injury scores were determined at end of the experiment.For the comparable ventilator setting, as compared with BIPAPSB group, the BIPAPAP group presented higher EELV (427±47 vs. 366±38 ml and oxygenation index (293±36 vs. 226±31 mmHg, lower levels of IL-6(216.6±48.0 vs. 297.5±71.2 pg/ml and IL-8(246.8±78.2 vs. 357.5±69.3 pg/ml in plasma, and lower express levels of IL-6 mRNA (15.0±3.8 vs. 21.2±3.7 and IL-8 mRNA (18.9±6.8 vs. 29.5±7.9 in lung tissues. In addition, less lung histopathology injury were revealed in the BIPAPAP group (22.5±2.0 vs. 25.2±2.1.Abdominal muscle activity during mechanically ventilation is one of the injurious factors in severe ARDS, so abdominal muscle paralysis might be an effective strategy to minimize ventilator-induce lung injury.

  1. Gut-directed hypnotherapy in children with irritable bowel syndrome or functional abdominal pain (syndrome): A randomized controlled trial on self exercises at home using CD versus individual therapy by qualified therapists

    J.M.T.M. Rutten (Juliette); A.M. Vlieger (Arine M.); C. Frankenhuis (Carla); E.K. George (Elvira K.); M. Groeneweg (Michael); O.F. Norbruis (Obbe); W.E. Tjon A ten; H. Van Wering (Herbert); M.G.W. Dijkgraaf (Marcel); M.P. Merkus; M.A. Benninga (Marc)

    2014-01-01

    textabstractBackground: Irritable bowel syndrome (IBS) and functional abdominal pain (syndrome) (FAP(S)) are common pediatric disorders, characterized by chronic or recurrent abdominal pain. Treatment is challenging, especially in children with persisting symptoms. Gut-directed hypnotherapy (HT) per

  2. Müllerian intra-abdominal carcinomatosis in hereditary breast ovarian cancer syndrome: implications for risk-reducing surgery.

    Casey, Murray Joseph; Colanta, Agnes B

    2016-07-01

    More than 40 years ago Lynch et al. described several multigenerational breast cancer family pedigrees which demonstrated autosomal dominant inheritance of a trait(s) that increased risks for both breast and ovarian cancers. Mutation carriers in at least 90 % of these hereditary breast ovarian cancer (HBOC) syndrome families have been linked to cancer-associated mutations in the genes BRCA1 and BRCA2. This review focuses on the contributions of Lynch, colleagues and collaborators and pertinent literature, toward defining the HBOC syndrome, the cancer risks that the inherited adverse mutations convey, the gynecologic tissues and organs from which the malignancy may arise to disseminate throughout the pelvic and abdominal organs and peritoneum and how this information can be used to reduce the risk and morbidities of intra-abdominal carcinomatosis in effected individuals. PMID:26875157

  3. Coexpression network analysis in abdominal and gluteal adipose tissue reveals regulatory genetic loci for metabolic syndrome and related phenotypes

    Min, Josine L; Nicholson, George; Halgrimsdottir, Ingileif; Almstrup, Kristian; Petri, Andreas; Barrett, Amy; Travers, Mary; Rayner, Nigel W; Mägi, Reedik; Pettersson, Fredrik H; Broxholme, John; Neville, Matt J; Wills, Quin F; Cheeseman, Jane; Allen, Maxine; Holmes, Chris C; Spector, Tim D; Fleckner, Jan; McCarthy, Mark I; Karpe, Fredrik; Lindgren, Cecilia M; Zondervan, Krina T

    2012-01-01

    Metabolic Syndrome (MetS) is highly prevalent and has considerable public health impact, but its underlying genetic factors remain elusive. To identify gene networks involved in MetS, we conducted whole-genome expression and genotype profiling on abdominal (ABD) and gluteal (GLU) adipose tissue, ...... interactions influence complex traits such as MetS, integrated analysis of genotypes and coexpression networks across multiple tissues relevant to clinical traits is an efficient strategy to identify novel associations....

  4. Calcific myonecrosis. A late sequela to compartment syndrome of the leg.

    O'Keefe, R J; O'Connell, J X; Temple, H T; Scully, S P; Kattapuram, S V; Springfield, D S; Rosenberg, A E; Mankin, H J

    1995-09-01

    The clinicopathologic features of calcific myonecrosis are presented from results of an examination of 3 cases of this rare syndrome and review of the literature. Calcific myonecrosis is a painful, expansile, calcified mass that develops in muscle several decades after lower extremity trauma that typically has been associated with vascular injury. Plain radiographs show a well-defined and heavily calcified mass replacing the leg musculature. The calcifications are present in a thin, linear pattern and are organized around the periphery of the lesion. Smooth erosion of the adjacent bone may be present, whereas magnetic resonance imaging shows a heterogeneous signal with enhancement limited to the periphery of the mass. Pathologic features consist of a centrally cystic mass arising in muscle filled with friable, tan to dark red, soft debris. The cyst walls are firm and fibrous and contain many needle-like, elongated, calcified shards of necrotic tissue composed of hypocellular fibrous tissue with focal aggregates of hemosiderin-laden macrophages. The cyst contents are composed of necrotic skeletal muscle and acellular amorphous debris containing many cholesterol crystals, fibrin, and recent hemorrhage, including focal aggregates of organizing thrombus. The pathologic findings suggest that calcific myonecrosis might expand with time by virtue of recurrent intralesional hemorrhage into a chronic calcified mass that eventually becomes symptomatic. Surgical intervention is associated with a high rate of complication, particularly in cases in which intralesional procedures have been done. PMID:7671519

  5. Anteroposterior diameter of the infrarenal abdominal aorta is higher in women with polycystic ovary syndrome

    Marco Matteo Ciccone

    2009-06-01

    Full Text Available Marco Matteo Ciccone1, Stefano Favale1, Anish Bhuva4, Pietro Scicchitano1, Vito Caragnano1, Cristina Lavopa2, Giovanni De Pergola3, Giuseppe Loverro21Department of Cardiology; 2Department of Gynecology and Obstetrics; 3Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari, DETO, Italy; 4University College of London, London, UKBackground: Women affected by polycystic ovary syndrome (PCOS are known to be at higher risk of cardiovascular disease. The aim of this study was to identify the artery that first is affected by early pre-atherosclerotic changes in PCOS. Methods: Twenty-nine women with PCOS aged 17 to 27 years and 26 healthy nonhyperandrogenic volunteers with regular menses (control women aged 16 to 28 years were enrolled. All PCOS patients were overweight or obese (body mass index [BMI] ≥ 25. Diagnosis of PCOS was performed in line with the 2003 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Accordingly, PCOS was defined when at least two of the following three features were present after exclusion of other etiologies: 1 oligomenorrhea and or anovulation; 2 hyperandrogenism and/or hyperandrogenemia; and 3 polycystic ovaries visible at ultrasound. Androgen excess or related disorders were excluded. The intima-media thickness (IMT of common carotid arteries and common femoral arteries and the anteroposterior diameter of the infrarenal abdominal aorta were measured by ultrasound. Lutenizing hormone (LH, follicle-stimulating hormone (FSH, estradiol, total testosterone, androstenedione, and sex hormone-binding globulin (SHBG serum levels were measured between the 3rd and the 6th day of spontaneous or progestin-induced menstrual cycle. Our study was performed in the absence of any medical treatment. Results: Women with PCOS showed a higher LH to FSH ratio (p < 0.01, increased fasting insulin (p < 0.001, total testosterone (p < 0.001, and androstenedione (p < 0.001 levels, and lower

  6. Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain

    Fabio Pace; Giovanna Zuin; Stefania Di Giacomo; Paola Molteni; Valentina Casini; Massimo Fontana; Gabriele Bianchi Porro

    2006-01-01

    AIM: To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain (RAP) or irritable bowel syndrome (IBS).METHODS: A group of 67 children with RAP referred to the department from January 1986 to December 1995was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview.We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history of IBS in comparison with adults with no persistent abdominal complaint.RESULTS: Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up (29%)whereas the majority (37 subjects) did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining (40.0% vs 16.0%), respectively (P < 0.05 at Student t test).Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances.CONCLUSION: The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms,possibly through the learning of a specific illness behavior.

  7. Surgical Treatment of Intra-Abdominal Desmoid Tumors Resulting In Short Bowel Syndrome

    Jon Thompson; David Mercer; Wendy Grant; Jean Botha; Alan Langnas; Matthew Wheeler

    2012-01-01

    Advanced intra-abdominal desmoids tumors present with severe symptoms, complications or rapid growth, which lead to adverse outcomes. Our aim was to evaluate the treatment and outcome of patients with advanced intra-abdominal desmoids tumors, and develop guidelines for surgical management of these patients. We reviewed the clinical courses of 21 adult patients with advanced stage intra-abdominal desmoid tumors who presented to an intestinal rehabilitation and transplantation program. Patients...

  8. Evaluation of the impact of abdominal obesity on glucose and lipid metabolism disorders in adults with Down syndrome.

    Real de Asua, Diego; Parra, Pedro; Costa, Ramón; Moldenhauer, Fernando; Suarez, Carmen

    2014-11-01

    We aimed to describe anthropometric differences in weight-related disorders between adults with Down syndrome (DS) and healthy controls, as well as their disparate impact on glucose and lipid metabolism disorders. We underwent a cross-sectional study of 49 consecutively selected, community-residing adults with DS and 49 healthy controls in an outpatient clinic of a tertiary care hospital in Madrid, Spain. Siblings of adults with DS were studied as controls in 42 cases. Epidemiological data (age and gender), anthropometric data (body mass index, waist circumference, and waist-to-height ratio [WHR]), coexisting clinical conditions, and laboratory data (fasting glucose, insulin, glycated hemoglobin, creatinine, thyroid hormones, and lipid profile) were measured and compared between the groups. Adults with DS were significantly younger and more often male, with a higher prevalence of overweight and obesity than controls. Adults with DS also had a higher WHR, and more frequently presented abdominal obesity. Moreover, insulin resistance measured using the homeostatic model assessment was more prevalent among adults with DS and abdominal obesity. However, lipid profiles were similar between groups. The kappa correlation index for the diagnosis of abdominal obesity between waist circumference and WHR was 0.24 (95%CI: 0.13-0.34). We concluded that the prevalence of overweight, obesity, and abdominal obesity was higher in adults with DS than in controls. Adults with DS and abdominal obesity showed higher indexes of insulin resistance than their non-obese peers. WHR was a useful tool for the evaluation of abdominal obesity in this population. PMID:25108610

  9. Surfactant disaturated-phosphatidylcholine kinetics in acute respiratory distress syndrome by stable isotopes and a two compartment model

    Cogo Paola E

    2007-02-01

    Full Text Available Abstract Background In patients with acute respiratory distress syndrome (ARDS, it is well known that only part of the lungs is aerated and surfactant function is impaired, but the extent of lung damage and changes in surfactant turnover remain unclear. The objective of the study was to evaluate surfactant disaturated-phosphatidylcholine turnover in patients with ARDS using stable isotopes. Methods We studied 12 patients with ARDS and 7 subjects with normal lungs. After the tracheal instillation of a trace dose of 13C-dipalmitoyl-phosphatidylcholine, we measured the 13C enrichment over time of palmitate residues of disaturated-phosphatidylcholine isolated from tracheal aspirates. Data were interpreted using a model with two compartments, alveoli and lung tissue, and kinetic parameters were derived assuming that, in controls, alveolar macrophages may degrade between 5 and 50% of disaturated-phosphatidylcholine, the rest being lost from tissue. In ARDS we assumed that 5–100% of disaturated-phosphatidylcholine is degraded in the alveolar space, due to release of hydrolytic enzymes. Some of the kinetic parameters were uniquely determined, while others were identified as lower and upper bounds. Results In ARDS, the alveolar pool of disaturated-phosphatidylcholine was significantly lower than in controls (0.16 ± 0.04 vs. 1.31 ± 0.40 mg/kg, p de novo synthesis of disaturated-phosphatidylcholine were also significantly lower, while mean resident time in lung tissue was significantly higher in ARDS than in controls. Recycling was 16.2 ± 3.5 in ARDS and 31.9 ± 7.3 in controls (p = 0.08. Conclusion In ARDS the alveolar pool of surfactant is reduced and disaturated-phosphatidylcholine turnover is altered.

  10. Abdominal trauma

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  11. Non-invasive neurosensory testing used to diagnose and confirm successful surgical management of lower extremity deep distal posterior compartment syndrome

    Guyton Gregory P

    2009-05-01

    Full Text Available Abstract Background Chronic exertional compartment syndrome (CECS is characterized by elevated pressures within a closed space of an extremity muscular compartment, causing pain and/or disability by impairing the neuromuscular function of the involved compartment. The diagnosis of CECS is primarily made on careful history and physical exam. The gold standard test to confirm the diagnosis of CECS is invasive intra-compartmental pressure measurements. Sensory nerve function is often diminished during symptomatic periods of CECS. Sensory nerve function can be documented with the use of non-painful, non-invasive neurosensory testing. Methods Non-painful neurosensory testing of the myelinated large sensory nerve fibers of the lower extremity were obtained with the Pressure Specified Sensory Device™ in a 25 year old male with history and invasive compartment pressures consistent with CECS both before and after running on a tread mill. After the patient's first operation to release the deep distal posterior compartment, the patient failed to improve. Repeat sensory testing revealed continued change in his function with exercise. He was returned to the operating room where a repeat procedure revealed that the deep posterior compartment was not completely released due to an unusual anatomic variant, and therefore complete release was accomplished. Results The patient's symptoms numbness in the plantar foot and pain in the distal calf improved after this procedure and his repeat sensory testing performed before and after running on the treadmill documented this improvement. Conclusion This case report illustrates the principal that non-invasive neurosensory testing can detect reversible changes in sensory nerve function after a provocative test and may be a helpful non-invasive technique to managing difficult cases of persistent lower extremity symptoms after failed decompressive fasciotomies for CECS. It can easily be performed before and after

  12. Compartments of the foot: topographic anatomy.

    Faymonville, C; Andermahr, J; Seidel, U; Müller, L P; Skouras, E; Eysel, P; Stein, G

    2012-12-01

    Recent publications have renewed the debate regarding the number of foot compartments. There is also no consensus regarding allocation of individual muscles and communication between compartments. The current study examines the anatomic topography of the foot compartments anew using 32 injections of epoxy-resin and subsequent sheet plastination in 12 cadaveric foot specimens. Six compartments were identified: dorsal, medial, lateral, superficial central, deep forefoot, and deep hindfoot compartments. Communication was evident between the deep hindfoot compartment and the superficial central and deep central forefoot compartments. In the hindfoot, the neurovascular bundles were located in separate tissue sheaths between the central hindfoot compartment and the medial compartment. In the forefoot, the medial and lateral bundles entered the deep central forefoot compartment. The deep central hindfoot compartment housed the quadratus plantae muscle, and after calcaneus fracture could develop an isolated compartment syndrome. PMID:22638720

  13. Acute intermittent porphyria leading to posterior reversible encephalopathy syndrome (PRES): a rare cause of abdominal pain and seizures.

    Dagens, Andrew; Gilhooley, Michael James

    2016-01-01

    Acute intermittent porphyria (AIP) is an inherited deficiency in the haem biosynthesis pathway. AIP is rare, affecting around 1 in 75 000 people. Acute attacks are characterised by abdominal pain associated with autonomic, neurological and psychiatric symptoms. AIP is rarely associated with posterior reversible encephalopathy syndrome (PRES). PRES is a clinicoradiological condition caused by the failure of the posterior circulation to autoregulate, resulting in cerebral oedema, headaches, nausea and seizures. This association is important because drugs used in the management of seizures may worsen an attack of AIP. This article describes a case of AIP and PRES in a young woman. PMID:27277587

  14. Surgical Treatment of Intra-Abdominal Desmoid Tumors Resulting In Short Bowel Syndrome

    Advanced intra-abdominal desmoids tumors present with severe symptoms, complications or rapid growth, which lead to adverse outcomes. Our aim was to evaluate the treatment and outcome of patients with advanced intra-abdominal desmoids tumors, and develop guidelines for surgical management of these patients. We reviewed the clinical courses of 21 adult patients with advanced stage intra-abdominal desmoid tumors who presented to an intestinal rehabilitation and transplantation program. Patients with massive intestinal resection presented in two groups. The first group had a short small intestinal remnant after resection (<60 cm). These patients were poor rehabilitation candidates and eventually met criteria for transplant. The second had longer intestinal remnants and were more successfully rehabilitated and have not had complications that would lead to transplantation. Advanced intra-abdominal desmoid tumors have outcomes after resection that merit aggressive resection and planned intestinal rehabilitation and intestinal transplantation as indicated

  15. Surgical Treatment of Intra-Abdominal Desmoid Tumors Resulting In Short Bowel Syndrome

    Jon Thompson

    2012-01-01

    Full Text Available Advanced intra-abdominal desmoids tumors present with severe symptoms, complications or rapid growth, which lead to adverse outcomes. Our aim was to evaluate the treatment and outcome of patients with advanced intra-abdominal desmoids tumors, and develop guidelines for surgical management of these patients. We reviewed the clinical courses of 21 adult patients with advanced stage intra-abdominal desmoid tumors who presented to an intestinal rehabilitation and transplantation program. Patients with massive intestinal resection presented in two groups. The first group had a short small intestinal remnant after resection ( < 60 cm. These patients were poor rehabilitation candidates and eventually met criteria for transplant. The second had longer intestinal remnants and were more successfully rehabilitated and have not had complications that would lead to transplantation. Advanced intra-abdominal desmoid tumors have outcomes after resection that merit aggressive resection and planned intestinal rehabilitation and intestinal transplantation as indicated.

  16. Surgical Treatment of Intra-Abdominal Desmoid Tumors Resulting In Short Bowel Syndrome

    Wheeler, Matthew; Mercer, David; Grant, Wendy; Botha, Jean; Langnas, Alan; Thompson, Jon, E-mail: jthompso@unmc.edu [Department of Surgery, University of Nebraska Medical Center, The Nebraska Medical Center 3280, Omaha, NE 68198 (United States)

    2012-01-19

    Advanced intra-abdominal desmoids tumors present with severe symptoms, complications or rapid growth, which lead to adverse outcomes. Our aim was to evaluate the treatment and outcome of patients with advanced intra-abdominal desmoids tumors, and develop guidelines for surgical management of these patients. We reviewed the clinical courses of 21 adult patients with advanced stage intra-abdominal desmoid tumors who presented to an intestinal rehabilitation and transplantation program. Patients with massive intestinal resection presented in two groups. The first group had a short small intestinal remnant after resection (<60 cm). These patients were poor rehabilitation candidates and eventually met criteria for transplant. The second had longer intestinal remnants and were more successfully rehabilitated and have not had complications that would lead to transplantation. Advanced intra-abdominal desmoid tumors have outcomes after resection that merit aggressive resection and planned intestinal rehabilitation and intestinal transplantation as indicated.

  17. CT findings of abdominal tuberculosis in patients with acquired immunodeficiency syndrome

    Objective: To study the CT findings of abdominal tuberculosis in patients with AIDS. Methods: CT imaging features of abdominal tuberculosis in 33 patients with AIDS were retrospectively analyzed. Results: Abdominal lymph adenopathy were observed in 23 cases (69.7%, 23/33). Hepatosplenomegaly were observed in 10 cases (30.3%, 10/33). Multiple low density nodes in spleen were observed in 14 cases (42.4%,14/33) including 9 cases of diffuse, low density nodes (27.3%, 9/33). Low density lesions in liver were observed in 7 cases (21.2%, 7/33) including a case of tuberculous abscess (3.0%, 1/33). Peritoneum and epiploon involvements were found in 5 cases (15.2%, 5/33) with associated ascites in 2 cases (6.1%, 2/33). Thickening of intestines wall were observed in 4 cases (12.1%, 4/33). Destruction of lumbar vertebra with cold abscess was observed in 1 case (3.0%, 1/33). Abscess in psoas was observed in 1 case (3.0%, 1/33). Conclusion: Abdominal tuberculosis in patients with AIDS usually involves multiple organs in the abdomen. CT has an important role in the detection and following up examination of these lesions. (authors)

  18. Time-dependent diffusion in skeletal muscle with the random permeable barrier model (RPBM): Application to normal controls and chronic exertional compartment syndrome patients

    Sigmund, Eric E.; Novikov, Dmitry S.; Sui, Dabang; Ukpebor, Obehi; Baete, Steven; Babb, James S.; Liu, Kecheng; Feiweier, Thorsten; Kwon, Jane; Mcgorty, KellyAnne; Bencardino, Jenny; Fieremans, Els

    2014-01-01

    Purpose To collect diffusion tensor imaging (DTI) at multiple diffusion times Td in skeletal muscle in normal subjects and chronic exertional compartment syndrome (CECS) patients and analyze the data with the random permeable barrier model (RPBM) for biophysical specificity. Materials and Methods Using an IRB-approved HIPAA-compliant protocol, seven patients with clinical suspicion of CECS and eight healthy volunteers underwent DTI of the calf muscle in a Siemens MAGNETOM Verio 3-T scanner at rest and after treadmill exertion at 4 different diffusion times. Radial diffusion values λrad were computed for each of 7 different muscle compartments and analyzed with RPBM to produce estimates of free diffusivity D0, fiber diameter a, and permeability κ. Fiber diameter estimates were compared with measurements from literature autopsy reference for several compartments. Response factors (post/pre-exercise ratios) were computed and compared between normal controls and CECS patients using a mixed-model two-way analysis of variance. Results All subjects and muscle compartments showed nearly time-independent diffusion along and strongly time-dependent diffusion transverse to the muscle fibers. RPBM estimates of fiber diameter correlated well with corresponding autopsy reference. D0 showed significant (pmeasurements combined with appropriate tissue modeling can provide enhanced microstructural specificity for in vivo tissue characterization. In CECS patients, our results suggest that high-pressure interfiber edema elevates free diffusion and restricts exercise-induced fiber dilation. Such specificity may be useful in differentiating CECS from other disorders or in predicting its response to either physical therapy or fasciotomy. PMID:24610770

  19. 腹针治疗更年期综合征40例%Abdominal acupuncture for 40 cases of climacteric syndrome

    顾群; 朱文罡

    2011-01-01

    Climacteric syndrome,so-called symptoms before and after menopause in TCM,encompasses a series of symptoms due to disorder of endocrine and autonomic nerve caused by declination of ovary function during perimenopausal period.In western medicine,the major treatment is hormone replacement therapy.However,different opinions exist on estrogen application and its safety,which shows more contraindications and adverse reactions combined.From 2004,the author has applied abdominal acupuncture on 40 cases of climacteric syndrome.

  20. Acute compartment syndrome of the forearm and hand in a patient of spine surgery -A case report-

    Lee, Jung-ah; Jeon, Yeon Soo; Jung, Hong Soo; Kim, Hyung-Gun; Kim, Yong Shin

    2010-01-01

    A 38-year-old woman underwent a 4-hour operation in the prone position for a laminectomy at C4-7 and posterior cervical decompressive fusion at C7-T1 under general anesthesia. After undraping at the end of surgery, considerable swelling with many blisters of the left forearm and hand was observed. The chest roll at the left side had moved cephalad into the axilla and compressed the axillary structures. An emergency fasciotomy to decompress the compartments of the forearm and dorsal surface of...

  1. ‘Growing mushroom on the back’ following minimally invasive spine fixation: The theory of iatrogenic compartment syndrome revisited

    M.J. Asha, MSc, MRCS

    2015-12-01

    Full Text Available The authors report a case of lumbar para-spinal muscle herniation following percutaneous thoraco-lumbar pedicle screw fixation. This is suggested to be due to subclinical iatrogenic increase in the intra-compartmental pressure. The possibility of ‘Iatrogenic paraspinal compartment syndrome’ following minimally invasive spine techniques has been discussed previously by other authors. Nevertheless, no such case has been reported so far in the literature. The awareness of this potential complication might be helpful for spinal surgeons for early detection and management.

  2. The clinical management of abdominal ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: a review of current guidelines and recommendations.

    Pericleous, Marinos; Sarnowski, Alexander; Moore, Alice; Fijten, Rik; Zaman, Murtaza

    2016-03-01

    Several pathogenic processes have been implicated in the development of abdominal ascites. Portal hypertension, most usually in the context of liver cirrhosis, can explain about 75% of the cases, whereas infective, inflammatory and infiltrative aetiologies can account for the rest. In this article, we discuss the consensus best practice as published by three professional bodies for the management of ascites, spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS). The aim of this study was to compare available clinical guidelines and identify areas of agreement and conflict. We carried out a review of the guidance documentation published by three expert bodies including the British Society of Gastroenterology, the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD), as well as a wider literature search for ascites, SBP and HRS. Abdominal ultrasonography, diagnostic paracentesis and ascitic fluid cultures are recommended by all three guidelines, especially when there is strong clinical suspicion for infection. EASL and AASLD advocate the use of ascitic amylase and mycobacterial cultures/PCR when there is strong suspicion for tuberculosis and pancreatitis, respectively. Ascitic cytology can be useful when cancer is suspected and has a good diagnostic yield if performed correctly. EASL supports the use of urinary electrolytes for all patients; however, the British Society of Gastroenterology and AASLD only recommend their use for therapy monitoring. All three societies recommend cefotaxime as the antibiotic of choice for SBP and large-volume paracentesis for the management of ascites greater than 5 l in volume. For HRS, cautious diuresis, volume expansion with albumin and the use of vasoactive drugs are recommended. There appears to be good concordance between recommendations by the European, American and British guidelines for the management of ascites and the possible

  3. Autologous reconstruction of a complex form of Poland syndrome using 2 abdominal perforator free flaps.

    Masia, Jaume; Pons, Gemma; Loschi, Pietro; Sanchez Porro-Gil, Lidia; Nardulli, Maria Luisa; Olivares, Leyre

    2015-05-01

    Poland syndrome is the most frequent cause of congenital breast aplasia and hypoplasia. Breast and possible chest wall deformities can be treated with several surgical techniques, including implants, and pedicled or free flaps.We describe the case of a young patient with severe Poland syndrome with amastia, athelia, and deformity of the chest wall, and aplasia of 2 ribs. Marked hypoplasia of the ipsilateral latissimus dorsi muscle ruled out a reliable reconstructive option.Two perforator flaps were performed in a single-stage operation. A hemi-deep inferior epigastric perforator flap was harvested to correct the chest deformity, whereas the contralateral superficial inferior epigastric artery flap allowed breast reconstruction.No complications occurred and a subjectively and objectively pleasing cosmetic result was maintained at 3-year follow-up. PMID:24322640

  4. Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain

    Asad Jehangir

    2015-10-01

    Full Text Available While generally safe, the most feared complication of colonoscopy is perforation of the colon, occurring in nearly 1 in 1,000 procedures, and is more common when polypectomy is performed and electrocautery is used. Less commonly known is the post-polypectomy electrocoagulation syndrome, a transmural burn of the colon which mimics the signs and symptoms of perforation as well as the time course, but follows a benign course and can be treated conservatively.

  5. Medical image of the week: massive spontaneous intra-abdominal bleeding

    Alzoubaidi M

    2014-02-01

    Full Text Available A 67 year-old female with rheumatoid arthritis, on anti-TNF and corticosteroids, was admitted to the ICU with severe shock, likely hemorrhagic. She was on coumadin for atrial fibrillation. She was found to have severe coagulopathy and diffuse spontaneous abdominal bleeding (Figure 1. She also developed left popliteal artery thrombosis, with compartment syndrome requiring surgical intervention. Disseminated intravascular coagulation was her final diagnosis.

  6. Surfactant disaturated-phosphatidylcholine kinetics in acute respiratory distress syndrome by stable isotopes and a two compartment model

    Cogo Paola E; Toffolo Gianna; Ori Carlo; Vianello Andrea; Chierici Marco; Gucciardi Antonina; Cobelli Claudio; Baritussio Aldo; Carnielli Virgilio P

    2007-01-01

    Abstract Background In patients with acute respiratory distress syndrome (ARDS), it is well known that only part of the lungs is aerated and surfactant function is impaired, but the extent of lung damage and changes in surfactant turnover remain unclear. The objective of the study was to evaluate surfactant disaturated-phosphatidylcholine turnover in patients with ARDS using stable isotopes. Methods We studied 12 patients with ARDS and 7 subjects with normal lungs. After the tracheal instilla...

  7. Comparison of Body, Auricular, and Abdominal Acupuncture Treatments for Insomnia Differentiated as Internal Harassment of Phlegm-Heat Syndrome: An Orthogonal Design

    Yue Jiao; Ying Han; Xin Li; Yi-gong Fang; Zhao-hui Liu; Wen-na Zhou; Jin-cao Zhou; Zhong-chao Wu; Jin-hong Yang; Shao-yuan Li; Fan-ying Meng; Wei-wei Xu

    2015-01-01

    Objective. To identify the optimum treatment protocol for insomnia among auricular, body, and abdominal needling methods. Methods. A three-factor (3 needling protocols) and three-level experimental scheme was designed based on orthogonal method. 54 patients of insomnia differentiated as internal harassment of phlegm-heat syndrome were given two courses of acupuncture treatment (each with 20 times of acupuncture). The therapeutic effects were evaluated by comparing the Pittsburgh sleep quality...

  8. Mechanical ventilation and intra-abdominal hypertension: 'Beyond Good and Evil'.

    Pelosi, Paolo; Vargas, Maria

    2012-01-01

    Intra-abdominal hypertension is frequent in surgical and medical critically ill patients. Intra-abdominal hypertension has a serious impact on the function of respiratory as well as peripheral organs. In the presence of alveolar capillary damage, which occurs in acute respiratory distress syndrome (ARDS), intra-abdominal hypertension promotes lung injury as well as edema, impedes the pulmonary lymphatic drainage, and increases intra-thoracic pressures, leading to atelectasis, airway closure, and deterioration of respiratory mechanics and gas exchange. The optimal setting of mechanical ventilation and its impact on respiratory function and hemodynamics in ARDS associated with intra-abdominal hypertension are far from being assessed. We suggest that the optimal ventilator management of patients with ARDS and intra-abdominal hypertension would include the following: (a) intra-abdominal, esophageal pressure, and hemodynamic monitoring; (b) ventilation setting with protective tidal volume, recruitment maneuver, and level of positive end-expiratory pressure set according to the 'best' compliance of the respiratory system or the lung; (c) deep sedation with or without neuromuscular paralysis in severe ARDS; and (d) open abdomen in selected patients with severe abdominal compartment syndrome. PMID:23256904

  9. Morbidade respiratória nos pacientes com e sem síndrome pulmonar obstrutiva submetidos a cirurgia abdominal alta Respiratory morbidity in patients with and without pulmonary obstrutive syndrome after upper abdominal surgery

    E.D.B. Pereira

    2000-03-01

    Full Text Available OBJETIVO: Estudar a morbidade respiratória nos pacientes com síndrome pulmonar obstrutiva submetidos a cirurgia abdominal alta. CASUÍSTICA E MÉTODO: Durante o pré-operatório, 196 pacientes candidatos à cirurgia abdominal alta eletiva responderam a um questionário padronizado e logo em seguida realizaram espirometria. Houve acompanhamento no pós-operatório até a alta hospitalar ou óbito. Os pacientes foram divididos em quatro grupos: 27 pacientes com DPOC (diagnóstico de bronquite crônica ou enfisema e VEF1/CVFBACKGROUND: We wanted to determine the postoperative pulmonary complicatiosn after upper abdominal surgery in patients with pulmonary obstrutive syndrome. METHODS: We have studied 196 patients prospectively analyzed in preoperative period with spirometry and followed for observation of PPC. The patients were divided in four groups: COPD - those with chronic bronchitis or emphysema and VEF1/CVF 70% (23 patients. NORMAL - patients without pulmonary disease and normal spirometry (102 patients. RESULTS: Postoperative pulmonary complication was recognized when the patient presented atelectasis with clinical or gasometric alterations; bronchospasm that needed bronchodilator therapy; respiratory failure; mechanical ventilation or orotracheal entubation more than 48 hours in postosurgery period; tracheobronchitis characterized by the presence of purulent sputum with normal x-ray; pneumonia. Patients with pulmonary obstruction had experienced higher rates of pulmonar complications (32% vs 6%,p<0,05. The presence of obstuctive lung disease was associated with an increased number of ventilator days, but was not associeted with longer intensive care unit or hospital stay. CONCLUSIONS: The incidence of postoperative pulmonary complications was strongly associated with the presence of pulmonary obstrutive syndrome.

  10. Comparison of Body, Auricular, and Abdominal Acupuncture Treatments for Insomnia Differentiated as Internal Harassment of Phlegm-Heat Syndrome: An Orthogonal Design.

    Jiao, Yue; Han, Ying; Li, Xin; Fang, Yi-Gong; Liu, Zhao-Hui; Zhou, Wen-Na; Zhou, Jin-Cao; Wu, Zhong-Chao; Yang, Jin-Hong; Li, Shao-Yuan; Meng, Fan-Ying; Xu, Wei-Wei

    2015-01-01

    Objective. To identify the optimum treatment protocol for insomnia among auricular, body, and abdominal needling methods. Methods. A three-factor (3 needling protocols) and three-level experimental scheme was designed based on orthogonal method. 54 patients of insomnia differentiated as internal harassment of phlegm-heat syndrome were given two courses of acupuncture treatment (each with 20 times of acupuncture). The therapeutic effects were evaluated by comparing the Pittsburgh sleep quality index (PSQI), Hamilton Depression Scale (HAMD) scores, and Hamilton Anxiety Scale (HAMA) scores of patients before treatment, after one course of treatment, and after two courses of treatment as well as one month after treatment. Results. Body, auricular, and abdominal acupuncture treatments all alleviated symptoms of insomnia, depression, and anxiety, but body and auricular acupuncture had stronger therapeutic effects. Conclusions. Body acupuncture at basic points shall be given priority in protocol selection for insomnia. The second-best choice is auricular acupuncture with basic points combined with points based on Traditional Chinese Medicine (TCM) theories. Abdominal needling with very quick effect can be an alternative protocol with basic points combined with syndrome differentiation points. PMID:26640498

  11. Comparison of Body, Auricular, and Abdominal Acupuncture Treatments for Insomnia Differentiated as Internal Harassment of Phlegm-Heat Syndrome: An Orthogonal Design

    Yue Jiao

    2015-01-01

    Full Text Available Objective. To identify the optimum treatment protocol for insomnia among auricular, body, and abdominal needling methods. Methods. A three-factor (3 needling protocols and three-level experimental scheme was designed based on orthogonal method. 54 patients of insomnia differentiated as internal harassment of phlegm-heat syndrome were given two courses of acupuncture treatment (each with 20 times of acupuncture. The therapeutic effects were evaluated by comparing the Pittsburgh sleep quality index (PSQI, Hamilton Depression Scale (HAMD scores, and Hamilton Anxiety Scale (HAMA scores of patients before treatment, after one course of treatment, and after two courses of treatment as well as one month after treatment. Results. Body, auricular, and abdominal acupuncture treatments all alleviated symptoms of insomnia, depression, and anxiety, but body and auricular acupuncture had stronger therapeutic effects. Conclusions. Body acupuncture at basic points shall be given priority in protocol selection for insomnia. The second-best choice is auricular acupuncture with basic points combined with points based on Traditional Chinese Medicine (TCM theories. Abdominal needling with very quick effect can be an alternative protocol with basic points combined with syndrome differentiation points.

  12. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management.

    Misra, A; Chowbey, P; Makkar, B M; Vikram, N K; Wasir, J S; Chadha, D; Joshi, Shashank R; Sadikot, S; Gupta, R; Gulati, Seema; Munjal, Y P

    2009-02-01

    Asian Indians exhibit unique features of obesity; excess body fat, abdominal adiposity, increased subcutaneous and intra-abdominal fat, and deposition of fat in ectopic sites (liver, muscle, etc.). Obesity is a major driver for the widely prevalent metabolic syndrome and type 2 diabetes mellitus (T2DM) in Asian Indians in India and those residing in other countries. Based on percentage body fat and morbidity data, limits of normal BMI are narrower and lower in Asian Indians than in white Caucasians. In this consensus statement, we present revised guidelines for diagnosis of obesity, abdominal obesity, the metabolic syndrome, physical activity, and drug therapy and bariatric surgery for obesity in Asian Indians after consultations with experts from various regions of India belonging to the following medical disciplines; internal medicine, metabolic diseases, endocrinology, nutrition, cardiology, exercise physiology, sports medicine and bariatric surgery, and representing reputed medical institutions, hospitals, government funded research institutions, and policy making bodies. It is estimated that by application of these guidelines, additional 10-15% of Indian population would be labeled as overweight/obese and would require appropriate management. Application of these guidelines on countrywide basis is also likely to have a deceleration effect on the escalating problem of T2DM and cardiovascular disease. These guidelines could be revised in future as appropriate, after another large and countrywide consensus process. Till that time, these should be used by clinicians, researchers and policymakers dealing with obesity and related diseases. PMID:19582986

  13. Síndrome compartimental em perna após reconstrução de ligamento cruzado anterior: relato de caso Leg's compartment syndrome after reconstruction of the anterior cruciate ligament: case report

    Jorge Sayum Filho; Leonardo Adeo Ramos; Jorge Sayum; Rogério Teixeira de Carvalho; Benno Ejnisman; Marcelo Mitsuro Matsuda; Alexandre Nicolini; Moisés Cohen

    2011-01-01

    Os autores apresentam o relato de caso de um paciente que foi submetido à cirurgia de reconstrução de ligamento cruzado anterior e reparo de ligamento colateral medial de joelho esquerdo e que evoluiu com síndrome de compartimento de perna.The authors report a case of a patient that was submitted to a surgery of reconstruction of anterior cruciate ligament and collateral medial ligament repair of the left knee that complicated to a compartment syndrome.

  14. Quantitation of stress/rest {sup 201}TI SPECT of the legs in the diagnosis of compartment-NT syndromes (CPS)

    Hayes, A.A.; Bower, G.D.; Pitstock, K.L.; Maguire, K.F.

    1998-03-01

    Full text: Compartment-NT syndrom (CPS) of the legs is considered to have an ischaemic basis related to muscle swelling and pressure increase in a muscle compartment (MC) during isotonic work. We decided to study selected patients where CPS was suspected with exercise {sup 201}TI SPECT of the legs to better define their diagnoses. Eighteen patients with probable CPS reproduced their leg pain(s) during isotonic work, and 100 MBq of {sup 201}TI was given i.v. during continued work and pain. Anterior 300 sec. planar and 360 degree, elliptical SPECT studies were acquired five minutes after stress and again four hours later. Quantitation of whole calf and regional MC uptake was attempted after the first five patients were assessed qualitatively. Ten patients were men and eight were women. The mean age was 30.8 y. Four had localised posterior and three had anterior pain with 11 having mixed and bilateral symptoms. Five patients had had a bone scan in the past and nine had MC pressure studies done within a month of study. Six patients had had previous decompressive surgery and seven patients had surgery after stress/rest studies. Four asymptomatic cardiac patients (``controls``) were imaged after their cardiac {sup 201}TI studies and data used for comparison. Mean age of controls was 33 years. Generally even muscle uptake was seen on stress images with mean washout of {sup 201}TI of 12% (7-23%) being calculated on delayed images of controls. Painful MCs with qualitative reduction in uptake after stress showed a mean increase in {sup 201}TI of 25.7% (6-39%) on delayed imaging. Three patients with dramatic improvement in symptoms after surgery had shown a mean increase of 25.2% in delayed uptake in MCs on pre-operative studies. One patient showed washout of 11 and 15% from posterior MCs and had a poor response to subsequent surgery. Further clinical follow up in a large group of patients will be required to fully identify the place of Stress {sup 201}TI imaging of the legs

  15. Intra-abdominal hypertension and acute pancreatitis.

    Mifkovic, A; Skultety, J; Sykora, P; Prochotsky, A; Okolicany, R

    2013-01-01

    Intra-abdominal hypertension (IAH) contributes to organ dysfunction and leads to the development of the abdominal compartment syndrome (ACS). IAH and ACS are relatively frequent findings in patiens with severe acute pancreatitis (SAP) and are associated with deterioration in organ functions. The most affected are cardiovascular, respiratory and renal functions. The incidence of IAH in patients with SAP is approximately 60-80%. There is an accumulating evidence in human and animal studies that changes of perfusion, particularly to the microvasculature, are crucial events in the progression of acute pancreatitis (AP). The perfusion of the small and large intestine is impaired due to reduced arterial pressure, increased vascular resistence and diminished portal blood flow. Bacterial translocation has been described in patients with ACS, and this may apply to patients with SAP. Approximately 30-40% of SAP patients develop ACS because of pancreatic (retroperitoneal) inflammation, peripancreatic tissue edema, formation of fluid collections or abdominal distension. Surgical debridement was the preferred treatment to control necrotizing pancreatitis in the past. However, the management of necrotizing pancreatitis has changed over the last decade. The main objective of this article is to describe the association between IAH and AP and to emphasize this situation in clinical praxis as well (Fig. 1, Ref. 38). PMID:23406186

  16. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

    Qian Huang

    2016-01-01

    Full Text Available Open abdomen (OA has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient’s physiological condition allows.

  17. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure-A Review.

    Huang, Qian; Li, Jieshou; Lau, Wan-Yee

    2016-01-01

    Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient's physiological condition allows. PMID:26819597

  18. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

    Huang, Qian; Li, Jieshou; Lau, Wan-yee

    2016-01-01

    Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient's physiological condition allows. PMID:26819597

  19. Abdominal Adhesions

    ... adhesions? Abdominal adhesions can cause intestinal obstruction and female infertility—the inability to become pregnant after a year of trying. Abdominal adhesions can lead to female infertility by preventing fertilized eggs from reaching the uterus, ...

  20. Abdominal Ultrasound

    ... It is used to help diagnose pain or distention and evaluate the kidneys, liver, gallbladder, pancreas, spleen ... variety of conditions, such as: abdominal pain or distention. abnormal liver function. enlarged abdominal organ. stones in ...

  1. Chronic exertional compartment syndrome of the lower extremities: improved screening using a novel dual birdcage coil and in-scanner exercise protocol

    The purpose of this study was to design and evaluate an MRI screening protocol for chronic exertional compartment syndrome (CECS) of the lower legs using an in-scanner exercise protocol and novel dual birdcage coil design for improved imaging. Coil and phantom studies: a custom-made dual birdcage coil designed for this protocol was evaluated for uniformity and signal-to-noise ratio (SNR) compared with a conventional phased-array receive-only torso coil and the body coil. Phantom and normal subject studies were performed to confirm coil performance. In-vivo studies: eight unaffected subjects and 42 patients with lower extremity symptoms suggestive of CECS were imaged with the dual birdcage coil and an in-scanner exercise protocol which included imaging at rest, during isometric resisted dorsi flexion, at rest (recovery), during isometric resisted plantar flexion and, again, at rest. Of 42 patients, 14 had confirmed CECS and 28 had lower extremity anomalies attributable to other causes. Ratios of relative T2-weighted signal intensities were calculated for exercise and recovery images compared to baseline after processing of images, including re-registration for motion, smoothing and segmentation to remove bone and pulsation artifacts from blood vessels. Receiver operating characteristic (ROC) analysis showed a threshold for the ratio of relative T2-weighted signal intensity of 1.54 to have a sensitivity of 96%, specificity of 90% and accuracy of 96% for CECS. Patients with CECS had their peak ratio of signal intensity compared with baseline during the first recovery period after isometric dorsi flexion, whereas unaffected subjects and patients with other causes of exercise-induced lower extremity pain reached their peak values during exercise (P < 0.001). We have developed the first in-scanner MRI exercise protocol for the assessment of patients with suspected CECS. The technique shows high accuracy, sensitivity and specificity for diagnosis in this small cohort of

  2. Síndrome compartimental em perna após reconstrução de ligamento cruzado anterior: relato de caso Leg's compartment syndrome after reconstruction of the anterior cruciate ligament: case report

    Jorge Sayum Filho

    2011-01-01

    Full Text Available Os autores apresentam o relato de caso de um paciente que foi submetido à cirurgia de reconstrução de ligamento cruzado anterior e reparo de ligamento colateral medial de joelho esquerdo e que evoluiu com síndrome de compartimento de perna.The authors report a case of a patient that was submitted to a surgery of reconstruction of anterior cruciate ligament and collateral medial ligament repair of the left knee that complicated to a compartment syndrome.

  3. The relationship of breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome in young adults. NHANES 1999-2006

    The goal of this study was to examine the association between breakfast skipping and type of breakfast consumed with overweight /obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome. Three breakfast groups were identified (breakfast skippers, ready-to-eat-cereal ...

  4. Abdominal Assessment.

    Fritz, Deborah; Weilitz, Pamela Becker

    2016-03-01

    Abdominal pain is one of the most common complaints by patients, and assessment of abdominal pain and associated symptoms can be challenging for home healthcare providers. Reasons for abdominal pain are related to inflammation, organ distention, and ischemia. The history and physical examination are important to narrow the source of acute or chronic problems, identify immediate interventions, and when necessary, facilitate emergency department care. PMID:26925941

  5. Mechanical Intestinal Obstruction in a Porcine Model: Effects of Intra-Abdominal Hypertension. A Preliminary Study

    Sánchez-Margallo, F. M.; Latorre, R.; López-Albors, O.; Wise, R.; Malbrain, M. L. N. G.; Castellanos, G.

    2016-01-01

    Introduction Mechanical intestinal obstruction is a disorder associated with intra-abdominal hypertension and abdominal compartment syndrome. As the large intestine intraluminal and intra-abdominal pressures are increased, so the patient’s risk for intestinal ischaemia. Previous studies have focused on hypoperfusion and bacterial translocation without considering the concomitant effect of intra-abdominal hypertension. The objective of this study was to design and evaluate a mechanical intestinal obstruction model in pigs similar to the human pathophysiology. Materials and Methods Fifteen pigs were divided into three groups: a control group (n = 5) and two groups of 5 pigs with intra-abdominal hypertension induced by mechanical intestinal obstruction. The intra-abdominal pressures of 20 mmHg were maintained for 2 and 5 hours respectively. Hemodynamic, respiratory and gastric intramucosal pH values, as well as blood tests were recorded every 30 min. Results Significant differences between the control and mechanical intestinal obstruction groups were noted. The mean arterial pressure, cardiac index, dynamic pulmonary compliance and abdominal perfusion pressure decreased. The systemic vascular resistance index, central venous pressure, pulse pressure variation, airway resistance and lactate increased within 2 hours from starting intra-abdominal hypertension (p<0.05). In addition, we observed increased values for the peak and plateau airway pressures, and low values of gastric intramucosal pH in the mechanical intestinal obstruction groups that were significant after 3 hours. Conclusion The mechanical intestinal obstruction model appears to adequately simulate the pathophysiology of intestinal obstruction that occurs in humans. Monitoring abdominal perfusion pressure, dynamic pulmonary compliance, gastric intramucosal pH and lactate values may provide insight in predicting the effects on endorgan function in patients with mechanical intestinal obstruction. PMID

  6. Study on Effect of Kangyanling(抗炎灵) on Cytokine and C-Reactive Protein inPatients of Systemic Inflammatory Reaction Syndrome and Multi-Organ Dysfunction Syndrome after Abdominal Surgery

    陈哲宇; 齐清会

    2001-01-01

    Objective: To observe the clinical efficacy and mechanism of Kangyanling (KYL) in treating patients with systemic inflammatory reaction syndrome and multi-organ dysfunction syndrome (SIRS/MODS) after abdominal surgery. Methods: Eighty-two patients of SIRS/MODS after abdominal surgery were divided into two groups according to admission time, the KYL treated group (n=35) and the control group (n=47). The levels of serum C-reactive protein (CRP), plasma tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) were measured at the 1st, 3rd and 7th days post-operationally. Results: The levels of CRP, TNFα and IL-6 decreased gradually after surgical operation in both groups, but the reducing velocity was shorter in the KYL group than that in the control group, so the comparison of the levels in the two groups showed significant difference on the 3rd day after operation. Conclusion:KYL could inhibit the release of inflammatory mediator and relieve the inflammatory response so as to treat post-operational SIRS/MODS effectively.

  7. Cut off values for abdominal obesity as a criterion of metabolic syndrome in an ethnic Kyrgyz population (Central Asian region)

    Mirrakhimov Aibek E; Lunegova Olga S; Kerimkulova Alina S; Moldokeeva Cholpon B; Nabiev Malik P; Mirrakhimov Erkin M

    2012-01-01

    Abstract Background People of different racial and ethnic backgrounds have a distinct pattern of central fat deposition, thus making it necessary to devise a race based approach for the diagnosis and evaluation of abdominal obesity (AO). This is the first study to determine the optimal waist circumference (WC) cutoff values for definition of AO in an ethnic Kyrgyz population. Methods 323 persons of Kyrgyz ethnicity (183 women and 140 men), with a mean age of 51.8 ± 9.5 years old were included...

  8. Peroneal nerve palsy due to compartment syndrome after facial plastic surgery Paralisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da face

    Clécio O. Godeiro-Júnior

    2007-09-01

    Full Text Available A 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur.Logo após ritidoplastia bilateral, um jovem de 25 anos apresentou agitação, necessitando uso de haloperidol. Algumas horas após, desenvolveu dor intensa em membros inferiores, e o diagnóstico de síndrome neuroléptica maligna foi considerado. Mesmo com o tratamento para tal, persistiu com dor. Após 12 horas do início do quadro, foi realizado o diagnóstico de síndrome compartimental de membros inferiores e o jovem foi submetido a fasciotomia bilateral. Uma seqüência de eventos desencadeou esta síndrome, já que sua ocorrência dificilmente seria justificada pela cirurgia facial e/ou posição do paciente durante o procedimento. O jovem apresentava previamente dor em membros inferiores aos exercícios, sugerindo a ocorrência de uma s

  9. [EXPERIENCE OF RELAPAROTOMY APPLICATION IN SURGICAL TREATMENT OF THE ABDOMINAL CAVITY ORGANS DISEASES].

    Malyk, S V; Podlesnyi, V I; Lavrenko, D O; Ksyonz, I V

    2015-10-01

    During 2011 - 2014 yrs in Surgical Clinic of The First City Clinic (Poltava) a relaparotomy was performed in 127 patients. There was established, that relaparotomy constitutes the only one procedure for such life threatening states, as intraabdominal bleeding, ileus in a decompensation stage, eventration, progressing peritonitis, abdominal compartment syndrome stages III - IV. The rate of relaparotomy application after performance of urgent operative interventions is bigger than after planned operations (ratio 4:1). Individual estimation of a state and choice of optimal surgical tactics during primary and secondary operative interventions are needed to improve the results of treatment. PMID:26946667

  10. Selective activation of intra-muscular compartments within the trapezius muscle in subjects with Subacromial Impingement Syndrome. A case-control study

    Larsen, C M; Juul-Kristensen, B; Olsen, H B;

    2014-01-01

    Neuromuscular control of the scapular muscles is important in the etiology of shoulder pain. Electromyographical (EMG) biofeedback in healthy people has been shown to support a selective activation of the lower compartment of the trapezius muscle, specifically. The aim of the present paper was to...... indicated that individuals with SIS may benefit from biofeedback training to gain control of the neuromuscular function of the scapular muscle....

  11. Gastrointestinal (GI) permeability is associated with trait anxiety in children with functional abdominal pain (FAP) and Irritable Bowel Syndrome (IBS)

    FAP and IBS affect 10-15% of school age children and bear many physiological similarities to irritable bowel syndrome (IBS) in adults (e.g., functional pain, visceral hyperalgesia). Animal models of IBS have suggested a relationship between neonatal stress and increased GI permeability later in life...

  12. Abdominal aortic calcification quantified by the Morphological Atherosclerotic Calcification Distribution (MACD) index is associated with features of the metabolic syndrome

    Barascuk, Natasha; Ganz, Melanie; Nielsen, Mads;

    2011-01-01

    death from cardiovascular disease (CVD). In this study we investigated associations of MACD and AC24 with traditional metabolic-syndrome associated risk factors at baseline and after 8.3 years follow-up, to identify biological parameters that may account for the differential performance of these indices...

  13. Distinct defects in collagen microarchitecture underlie vessel-wall failure in advanced abdominal aneurysms and aneurysms in Marfan syndrome

    Lindeman, J.H.N.; Ashcroft, B.A.; Beenakker, J.-W.M.; Es, M. van; Koekkoek, N.B.R.; Prins, F.A.; Tielemans, J.F.; Abdul-Hussien, H.; Bank, R.A.; Oosterkamp, T.H.

    2010-01-01

    An aneurysm of the aorta is a common pathology characterized by segmentalweakeningof the artery.Althoughit isgenerally accepted that the vessel-wall weakening is caused by an impaired collagen metabolism, a clear association has been demonstrated only for rare syndromes such as the vascular type Ehl

  14. Abdominal trauma

    The potential for multiple intraperitoneal and retroperitoneal organ injuries often makes accurate clinical evaluation of abdominal trauma patients difficult. Additionally, patients may be unresponsive, have unreliable abdominal physical examinations, or have concurrent serious head and cervical spine injuries which delay diagnosis of and attention to abdominal problems. In these situations radiologic abdominal imaging is often requested. To expedite patient evaluation, close cooperation between the emergency physician and the radiologist is essential. It is the clinical stability of the traumatized patient that dictates the extent of radiologic imaging. Life-threatening hypotension, positive peritoneal signs, or clear evidence of penetrating abdominal injury are indications for immediate surgery. Stable patients with signs suggesting intra-abdominal injury will benefit by further radiologic evaluation with appropriate imaging modalities. The selection of an appropriate modality in any one clinical situation depends upon many criteria including accessibility to diagnostic equipment, the sensitivity and specificity of each technique, and the expertise and preference of the attending radiologist. A suggested scheme for evaluating abdominal trauma patients is presented. Most aspects of this evaluation scheme will be discussed in depth

  15. Updates on abdominal desmoid tumors

    2007-01-01

    Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequentiy after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management.

  16. Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry.

    Ayumi Ido

    Full Text Available Sarcopenia has never been diagnosed based on site-specific muscle loss, and little is known about the relationship between site-specific muscle loss and metabolic syndrome (MetS risk factors. To this end, this cross-sectional study aimed to investigate the relationship between site-specific muscle size and MetS risk factors. Subjects were 38 obese men and women aged 40-82 years. Total body fat and lean body mass were assessed by whole-body dual-energy X-ray absorptiometry (DXA scan. Muscle thickness (MTH was measured using B-mode ultrasound scanning in six body regions. Subjects were classified into general obesity (GO and sarcopenic obesity (SO groups using the threshold values of one standard deviation below the sex-specific means of either MTH or skeletal muscle index (SMI measured by DXA. MetS risk score was acquired by standardizing and summing the following continuously distributed variables: visceral fat area, mean blood pressure, HbA1c, and serum triglyceride / high density lipoprotein cholesterol, to obtain the Z-score. Multiple regression analysis revealed that the MetS risk score was independently associated with abdominal MTH in all subjects, but not with MTH in other muscle regions, including the thigh. Although HbA1c and the number of MetS risk factors in the SO group were significantly higher than those in the GO group, there were no significant differences between GO and SO groups as defined by SMI. Ultrasound-derived abdominal MTH would allow a better assessment of sarcopenia in obese patients and can be used as an alternative to the conventionally-used SMI measured by DXA.

  17. Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry.

    Ido, Ayumi; Nakayama, Yuki; Ishii, Kojiro; Iemitsu, Motoyuki; Sato, Koji; Fujimoto, Masahiro; Kurihara, Toshiyuki; Hamaoka, Takafumi; Satoh-Asahara, Noriko; Sanada, Kiyoshi

    2015-01-01

    Sarcopenia has never been diagnosed based on site-specific muscle loss, and little is known about the relationship between site-specific muscle loss and metabolic syndrome (MetS) risk factors. To this end, this cross-sectional study aimed to investigate the relationship between site-specific muscle size and MetS risk factors. Subjects were 38 obese men and women aged 40-82 years. Total body fat and lean body mass were assessed by whole-body dual-energy X-ray absorptiometry (DXA) scan. Muscle thickness (MTH) was measured using B-mode ultrasound scanning in six body regions. Subjects were classified into general obesity (GO) and sarcopenic obesity (SO) groups using the threshold values of one standard deviation below the sex-specific means of either MTH or skeletal muscle index (SMI) measured by DXA. MetS risk score was acquired by standardizing and summing the following continuously distributed variables: visceral fat area, mean blood pressure, HbA1c, and serum triglyceride / high density lipoprotein cholesterol, to obtain the Z-score. Multiple regression analysis revealed that the MetS risk score was independently associated with abdominal MTH in all subjects, but not with MTH in other muscle regions, including the thigh. Although HbA1c and the number of MetS risk factors in the SO group were significantly higher than those in the GO group, there were no significant differences between GO and SO groups as defined by SMI. Ultrasound-derived abdominal MTH would allow a better assessment of sarcopenia in obese patients and can be used as an alternative to the conventionally-used SMI measured by DXA. PMID:26700167

  18. Abdominal sounds

    ... during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation. Increased ( hyperactive ) bowel sounds ...

  19. Incidental Diagnosis of MEN1 Syndrome in a Pediatric Patient Presenting With Obstructive Jaundice and Abdominal Pain

    Cengia, Brent; Conway, Jason; Pawa, Rishi

    2016-01-01

    A 16-year-old adolescent boy presented with obstructive jaundice and was incidentally found to have a well-differentiated pancreatic endocrine neoplasm upon endoscopic ultrasound. The discovery of this tumor led to further investigation and the eventual diagnosis of MEN1 syndrome. The diagnosis of MEN1 can prove difficult, and lack of treatment has been shown to lead to early mortality. One must maintain clinical suspicion for this disease in the evaluation of patients presenting with suspicious lesions of unknown etiology, especially those involving the pancreas, anterior pituitary, and parathyroid glands. PMID:27144202

  20. Incidental Diagnosis of MEN1 Syndrome in a Pediatric Patient Presenting With Obstructive Jaundice and Abdominal Pain.

    Jones, Jason D; Cengia, Brent; Conway, Jason; Pawa, Rishi

    2016-04-01

    A 16-year-old adolescent boy presented with obstructive jaundice and was incidentally found to have a well-differentiated pancreatic endocrine neoplasm upon endoscopic ultrasound. The discovery of this tumor led to further investigation and the eventual diagnosis of MEN1 syndrome. The diagnosis of MEN1 can prove difficult, and lack of treatment has been shown to lead to early mortality. One must maintain clinical suspicion for this disease in the evaluation of patients presenting with suspicious lesions of unknown etiology, especially those involving the pancreas, anterior pituitary, and parathyroid glands. PMID:27144202

  1. Abdominal Sepsis.

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  2. Cut off values for abdominal obesity as a criterion of metabolic syndrome in an ethnic Kyrgyz population (Central Asian region

    Mirrakhimov Aibek E

    2012-02-01

    Full Text Available Abstract Background People of different racial and ethnic backgrounds have a distinct pattern of central fat deposition, thus making it necessary to devise a race based approach for the diagnosis and evaluation of abdominal obesity (AO. This is the first study to determine the optimal waist circumference (WC cutoff values for definition of AO in an ethnic Kyrgyz population. Methods 323 persons of Kyrgyz ethnicity (183 women and 140 men, with a mean age of 51.8 ± 9.5 years old were included in the study. Measurement of blood pressure (BP, anthropometric data (including body mass index calculation and WC measurement, fasting blood sugar, serum lipid parameters and insulin were performed in all examined individuals. Insulin resistance (IR was considered as HOMA index (insulin × fasting glucose/22.5 ≥ 2.77. Sensitivity and specificity for the presence of IR or two other criteria of MS (according to the international classification, 2009 were calculated by using receiver operating characteristic (ROC curves for men and women separately. Results The optimal sensitivity and specificity obtained from the ROC curves for IR were 88 cm in women (sensitivity of 0.85, 95%CI (0.72-0.93, specificity of 0.58, 95%CI (0.49-0.66 and 94 cm for men (sensitivity of 0.8, 95% CI (0.65-0.91, specificity of 0.61, 95% CI (0.51-0.71. The data from the ROC curve for any two other MS criteria confirmed the results and the WC 88 cm in women (sensitivity of 0.82, 95% CI (0.72-0.9, specificity of 0.72, 95% CI (0.62-0.8 and 94 cm in men (sensitivity of 0.74, 95% CI (0.62-0.84, specificity of 0.73, 95% CI (0.61-0.83 were corresponded to the optimal sensitivity and specificity. Conclusion WC ≥ 88 cm and ≥ 94 cm should be used as a criterion for the diagnosis of AO for Kyrgyz women and men respectively based on these results.

  3. Positive end expiratory pressure titrated by transpulmonary pressure improved oxygenation and respiratory mechanics in acute respiratory distress syndrome patients with intra-abdominal hypertension

    YANG Yi; LI Yang; LIU Song-qiao; LIU Ling; HUANG Ying-zi; GUO Feng-mei; QIU Hai-bo

    2013-01-01

    Background Intra-abdominal hypertension (IAH) is common in acute respiratory distress syndrome (ARDS) patients and when resulting in decrease of chest wall compliance will weaken the effect of positive end expiratory pressure (PEEP).We investigated the effect of PEEP titrated by transpulmonary pressure (Ptp) on oxygenation and respiratory mechanics in ARDS patients with IAH compared with PEEP titrated by ARDSnet protocol.Methods ARDS patients admitted to the intensive care unit (ICU) of the Zhongda Hospital were enrolled.Patients were ventilated with volume control mode with tidal volume of 6 ml/kg under two different PEEP levels titrated by Ptp method and ARDSnet protocol.Respiratory mechanics,gas exchange and haemodynamics were measured after 30 minutes of ventilation in each round.IAH was defined as intra-abdominal pressure of 12 mmHg or more.Results Seven ARDS patients with IAH and 8 ARDS patients without IAH were enrolled.PEEP titrated by Ptp were significant higher than PEEP titrated by ARDSnet protocol in both ARDS patients with IAH ((17.3±2.6) cmH2O vs.(6.3±1.6)cmH2O and without IAH ((9.5±2.1) cmH2O vs.(7.8±1.9) cmH2O).Arterial pressure of O2/fraction of inspired oxygen (PaO2/FiO2)was much higher under PEEP titrated by Ptp when compared with PEEP titrated by ARDSnet protocol in ARDS patients with IAH ((27.2±4.0) cmHg vs.(20.9± 5.0) cmHg.But no significant difference of PaO2/FiO2 between the two methods was found in ARDS patients without IAH.In ARDS patients with IAH,static compliance of lung and respiratory system were higher under PEEP titrated by Ptp than by ARDSnet protocol.In ARDS patients with IAH,central venous pressure (CVP) was higher during PEEP titrated by Ptp than byARDSnet protocol.Conclusion Positive end expiratory pressure titrated by transpulmonary pressure was higher than PEEP titrated by ARDSnet protocol and improved oxygenation and respiratory mechanics in ARDS patients with IAH.

  4. Fasciotomía profiláctica y síndrome "compartimental" de las extremidades: ¿existen indicaciones justificables? Prophylactic fasciotomy and compartment syndrome of the extremities: are there justifiable indications?

    Juan Carlos Gómez-Hoyos

    2011-06-01

    casos de trauma con un riesgo alto de síndrome "compartimental", como una lesión vascular combinada -principalmente, de vasos poplíteos-, con fractura o sin ella -principalmente, de tibia proximal- o luxación -principalmente, de rodilla-, hacen pensar que dicha intervención es recomendable. Las consecuencias de un síndrome "compartimental" en curso son más graves que las de una fasciotomía profiláctica innecesaria.Background. Fasciotomy is the core intervention to treat established compartment syndrome, however the ideal intervention would be one able to prevent is occurrence. Fasciotomy can also be performed as a prophylactic procedure for compartment syndrome, considered by some to be the best option; but other authors consider it unjustifiable because it is not void of complications. We studied and analyzed the available evidence for the possible indications for prophylactic fasciotomy. Materials and Methods. We performed a literature search following the BestBET methodology, identifying studies that could determine the impact of prophylactic fasciotomy and risk factors for possible complications. The articles were reviewed according to the STROBE critical appraisal criteria. Results. Four retrospective observational studies were identified, three of them identified risk factors for prophylactic fasciotomy and its impact, while the other related to the identification of risk factors. The most common localization was the leg (68.4%, the clinical scenarios with the highest risk for compartment syndrome were combined arterial and venous vascular trauma (41.8%, OR 3.0, IC 1,4-6.1, vascular trauma (arterial 27.2% OR 10.4 IC 7.1-15.4, venous 23.4% OR 7.4 IC 4.5-12.4, Bone fracture with associated with vascular trauma (44% vs. 19% and dislocation associated to vascular trauma (10.4% OR 3,5 IC 1.8-6.8. The risk increases significantly with popliteal vascular trauma, open fractures, proximal tibial fractures, and if knee dislocation occurs. There is no solid evidence

  5. Abdominal Pain

    ... relaxation. Guided imagery for abdominal pain About self-hypnosis and kids See YourChild : Pain and Your Child or Teen for more detail ... how to help your baby cope with the pain of medical procedures, circumcision, and teething. ... Helping Kids YourChild : A Look at Biofeedback YourChild : ...

  6. Treatment outcomes of muscle debridement in acute upper limb compartment syndrome%肌肉清创治疗上肢急性期筋膜室间隔综合征的疗效

    王晓刚; 宫可同; 殷中罡; 阚世廉; 李瑞华; 尹路; 鲁毅军; 张宝贵

    2014-01-01

    目的 探索急性期筋膜室间隔综合征患者肌肉清创的手术方法并评估术后疗效.方法 回顾性分析自2005年6月至2013年3月不同原因引起的急性期筋膜室间隔综合征患者13例,全部在筋膜减张的同时行肌肉内坏死组织清创及神经肌肉松解.结果 12例患者直接闭合创面,1例在12 d后延迟闭合创面;11例在术后3周左右获得Ⅰ期愈合;术后3周内9例获得不同程度的运动及感觉功能改善;术后3个月以上5例患者获得随访,对运动和感觉功能恢复较满意.结论 肌肉清创作为筋膜减张术的补充,降低了肌肉内坏死部分所占的比例,使急性期患者创面直接闭合及Ⅰ期愈合的比例升高,并能通过早期功能锻炼,促进患肢近期和远期的功能康复.%Objective To introduce the procedures of muscle debridement in acute compartment syndromes and evaluate the surgical outcomes.Methods From June 2005 to March 2013,thirteen patients who sustained acute compartment syndrome underwent fasciotomy,extensive debridement of necrotic portion of the involved muscles as well as release of nerves and muscles in the meantime.Results Direct wound closure was possible in 12 patients.Delayed wound incision closure in 12 days was done in one patient.Primary wound healing was achieved in 11 patients around 3 weeks postoperatively.Nine patients obtained varied degrees of improvement in both motor and sensory functions.Five patients were follow-up for more than 3 months and they were rather satisfied with the muscle strength and sensory recovery.Conclusion In addition to fasciotomy,debridement of involved muscles can decrease the extent of muscle necrosis in acute compartment syndrome patients.It also increases the chance of direct wound closure and primary wound healing,facilitates early rehabilitation,and thus leads to much better short-term and long-term functional outcomes.

  7. Morbidade respiratória nos pacientes com e sem síndrome pulmonar obstrutiva submetidos a cirurgia abdominal alta Respiratory morbidity in patients with and without pulmonary obstrutive syndrome after upper abdominal surgery

    E.D.B. Pereira; S.M. Farensin; A.L.G. Fernandes

    2000-01-01

    OBJETIVO: Estudar a morbidade respiratória nos pacientes com síndrome pulmonar obstrutiva submetidos a cirurgia abdominal alta. CASUÍSTICA E MÉTODO: Durante o pré-operatório, 196 pacientes candidatos à cirurgia abdominal alta eletiva responderam a um questionário padronizado e logo em seguida realizaram espirometria. Houve acompanhamento no pós-operatório até a alta hospitalar ou óbito. Os pacientes foram divididos em quatro grupos: 27 pacientes com DPOC (diagnóstico de bronquite crônica ou e...

  8. [Abbreviated laparotomy for treatment of severe abdominal trauma: use in austere settings].

    Balandraud, P; Biance, N; Peycru, T; Savoie, P H; Avaro, J P; Tardat, E; Pourrière, M; Cador, L

    2007-10-01

    Abbreviated laparotomy is a recent technique for management of patients with severe abdominal trauma. It is based on a unified approach taking into account the overall extent of injury and the victim's physiologic potential to respond to hemorrhage. It is the first step in a multi-modal strategy. The second step is the critical care phase. The third step consists of "second-look" laparotomy that should ideally be performed on an elective basis within 48 hours and is aimed at definitive treatment of lesions. The goal of abbreviated laparotomy is damage control using temporary quick-fix procedures limited to conspicuous lesions and rapid hemostasis and/or viscerostasis procedures so that the patient can survive the acute critical period. Tension-free closure of the abdominal wall, if necessary using laparostomy, is essential to avoid abdominal compartment syndrome. With reported survival rates of about 50% in Europe and the United States, this simple life-saving technique that requires limited resources should be introduced in Africa where severe abdominal trauma often involves young patients. PMID:18225739

  9. Abdominal migraine in childhood: a review

    Scicchitano B

    2014-08-01

    Full Text Available Beatrice Scicchitano,1 Gareth Humphreys,1 Sally G Mitton,2 Thiagarajan Jaiganesh1 1Children's Emergency Department, 2Department of Paediatric Gastroenterology, St Georges Hospital, St Georges Healthcare NHS Trust, Tooting, London, United Kingdom Abstract: The childhood condition of abdominal migraine has been described under many different synonyms, including "abdominal epilepsy", "recurrent abdominal pain", "cyclical vomiting syndrome", and "functional gastrointestinal disorder". In the early literature, abdominal migraine is included in the "childhood periodic syndrome", first described by Wyllie and Schlesinger in 1933. Abdominal migraine has emerged over the last century as a diagnostic entity in its own right thanks to the development of well defined diagnostic criteria and its recent inclusion in the International Headache Society's Classification of Headache disorders. Despite this progress, little is known about the pathophysiology of the condition, and the treatment options are poorly defined. Here we summarize the recent literature, with particular focus on establishing the diagnosis of abdominal migraine and its pathophysiology, and suggest an approach to management. Keywords: abdominal migraine, recurrent abdominal pain, abdominal epilepsy, cyclical vomiting

  10. Sonographic appearance of asplenia syndrome

    The findings of upper abdominal sonography in three patients with asplenia syndrome are reported. Beside the juxtaposition of the abdominal aorta and inferior vena cava, two additional signs of the asplenia syndrome are discussed: absent splenic vein in pancreatic sonography and midline portal vein. While upper abdominal sonography is not diagnostic in determining the absence or presence of splenic tissue, it seems to be helpful in the identification of upper abdominal vascular anatomy. By demonstrating juxtaposition of the abdominal aorta and inferior vena cava, absent splenic vein, and midline portal vein, upper abdominal sonography can play a significant part in the diagnosis of asplenia syndrome. Alternative diagnostic approaches are discussed. (orig.)

  11. Thin's abdominal acupuncture for treatment 0f failed back surgery syndrome in 20 cases of clinical observation%薄氏腹针治疗腰椎手术失败综合征20例临床观察

    黄海涛; 郑盛惠; 冯军; 王曙辉; 任蓉; 姜健; 杨丽霞

    2012-01-01

    目的:观察薄氏腹针治疗腰椎手术失败综合征的临床疗效及对血清前列腺素E2(PGE2)、白介素-1β(IL-1β)的影响.方法:将40例本病患者随机分为腹针组与常规针刺组各20例,另设正常组20例.腹针组采用腹针疗法,常规针刺组采用常规针刺疗法.观察两组的临床疗效并测定两组患者治疗前、后血清PGE2、IL-1β水平.结果:两组患者治疗后VAS评分均明显降低,腹针组优于常规针刺组,差异有统计学意义(P<0.05,P<0.01);腹针组总有效率为95.0%,常规针刺组为80.0%,两组比较,差异有统计学意义(P<0.05).两组患者治疗前血清PGE:、IL-1β水平较正常组升高,经治疗后均明显降低,以腹针组更加明显,差异有统计学意义(P<0.05,P<0.01).结论:腹针疗法治疗腰椎手术失败综合征疗效确切,能有效降低VAS评分及血清PCE2、IL-1β含量,可能为其作用机制之一.%Objective: To observe the clinical efficacy of abdominal acupuncture for treatment of thin's failed back surgery syndrome and serum prostaglandin E2 (PGE2), white interleukin-1 β (IL-1β). Methods: 40 cases the patients were randomly divided into 20 cases of abdominal acupuncture group and the routine acupuncture group, separate group of 20 cases. Abdominal acupuncture group were treated with abdominal acupuncture, routine acupuncture group with routine acupuncture. The clinical efficacy of the two groups were observed and measured the two groups of patients, serum PGE2, IL-1β levels. Results: After treatment, VAS scores were significantly lower abdominal acupuncture group was better than the routine acupuncture group, the difference was statistically significant(PP<0.05, <0.01); abdominal acupuncture group, the total effective rate was 95.0%, the conventional needle The acupuncture group was 80.0%, respectively, the difference was statistically significantP< 0.05). The two groups before treatment serum PGE2, IL-1β levels than the normal group increased

  12. 封闭负压引流技术治疗骨筋膜室综合征的护理体会%Nursing Experience of Vaccum Sealing Drainage in Treating Osteofascial Compartment Syndrome

    张亚军; 樊梅

    2012-01-01

    目的:探讨封闭负压引流技术治疗骨筋膜室综合征的护理方法.方法:对30例骨筋膜室综合征患者实施切开减压封闭负压引流术,同时给予一般护理、心理护理、引流管护理、疼痛护理、患肢未梢血运护理、饮食护理等护理措施.结果:30例骨筋膜室综合征患者全部得到有效治疗,无1例发生创面感染.游离植皮表面再次使用负压治疗吸附垫覆盖后,植皮存活率100%,存活面积95%~100%之间.结论:一般护理、心理护理、引流管护理、疼痛护理、患肢末梢血运护理、饮食护理等护理措施有助于保护封闭负压引流技术后的创面,避免感染.%Objective: To investigate nursing method for osteofascial compartment syndrome with vaccum sealing drainage (VSD). Method: Thirty patients were decompressed with VSD and given with nursing. Result: All patients were cured and no infection occurred. Survival rate of grafting skin was 100%, survival area was from 95% to 100%. Conclusion: Nursing measures containing conventional nursing, psychological nursing, drainage tube nursing, aching nursing, nursing for blood circulation of limb extremities and dietary nursing are helpful in protecting of wound surface after VSD and avoiding pollution.

  13. Functional Abdominal Bloating with Distention

    Sullivan, Stephen Norman

    2012-01-01

    Ten to 25% of healthy persons experience bloating. It is particularly common in persons with the irritable bowel syndrome and constipation. While the cause of bloating remains unknown old explanations such as a excessive intestinal gas, exaggerated lumbar lordosis and psychiatric problems have been disproved. New suggestions include recent weight gain, weak or inappropriately relaxed abdominal muscles, an inappropriately contracted diaphragm and retained fluid in loops of distal small bowel. ...

  14. Abdominal Aortic Aneurysms: Treatments

    ... access catheters Vertebroplasty Women and vascular disease Women's health Social Media Facebook Twitter ... Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists are vascular ...

  15. Modeling of compartment fire

    Fire accident in a containment is a serious threat to nuclear reactors. Fire can cause substantial loss to life and property. The risk posed by fire can also exceed the risk from internal events within a nuclear reactor. Numerous research efforts have been performed to understand and analyze the phenomenon of fire in nuclear reactor and its consequences. Modeling of fire is an important subject in the field of fire safety engineering. Two approaches which are commonly used in fire modeling are zonal modeling and field modeling. The objective of this work is to compare zonal and field modeling approach against a pool fired experiment performed in a well-confined compartment. Numerical simulations were performed against experiments, which were conducted within PRISME program under the framework of OECD. In these experiments, effects of ventilation flow rate on heat release rate in a confined and mechanically ventilated compartment is investigated. Time dependent changes in gas temperature and oxygen mass fraction were measured. The trends obtained by numerical simulation performed using zonal model and field model compares well with experiments. Further validation is needed before this code can be used for fire safety analyses. (author)

  16. The use of body circumferences for the prediction of intra-abdominal fat in obese women with polycystic ovary syndrome El uso de circunferencias corporales para la predicción de la grasa intra-abdominal en mujeres obesas con el síndrome del ovario poliquístico

    F. Rodrigues de Oliveira Penaforte

    2012-10-01

    Full Text Available Introduction: Computerizd tomography (CT is the gold standard for the evaluation of intra- (IAF and total (TAF abdominal fat; however, the high cost of the procedure and exposure to radiation limit its routine use. Objective: To develop equations that utilize anthropometric measures for the estimate of IAF and TAF in obese women with polycystic ovary syndrome (PCOS. Methods: The weight, height, BMI, and abdominal (AC, waist (WC, chest (CC, and neck (NC circumferences of thirty obese women with PCOS were measured, and their IAF and TAF were analyzed by CT. Results: The anthropometric variables AC, CC, and NC were chosen for the TAF linear regression model because they were better correlated with the fat deposited in this region. The model proposed for TAF (predicted was: 4.63725 + 0.01483 x AC - 0.00117 x NC - 0.00177 x CC (R² = 0.78; and the model proposed for IAF was: IAF (predicted = 1.88541 + 0.01878 x WC + 0.05687 x NC -0.01529 x CC (R²=0.51. AC was the only independent predictor of TAF (p Introducción: La tomografia computarizada (TC es el estándar de oro para la evaluación de la grasa intra-abdominal (GIA y abdominal total (GAT, pero los altos costos y la exposición a la radiación limitan su uso rutinario. Objetivo: Desarrollar ecuaciones para la estimación de la GIA y la GAT en mujeres obesas con el sindrome del ovario poliquistico, utilizando medidas antropométricas. Métodos: Se evaluó el peso, la altura, el IMC y las circunferencias abdominal (CA, cintura (CC, pecho (CP y cuello (Ccu de 30 mujeres obesas con SOP. La GIA y GAT fueron analizados por la TC. Resultados: El modelo propuesto fue: GAT = 4,63725 + 0,01483 x CA - 0.00117 x CCu - 0,00177 x CP (R² = 0,78; y para la GIA fue: GIA = 1, 88541 + 0, 01878 x CC + 0,05687 x CCu - 0,01529 x CP (R² = 0,51. La CA fue La única variable predictora independiente de la GAT (p < 0,01. Conclusión: Las equaciones propuestas correlacionaronse bien con el valor real, medido a trav

  17. Abdominal trauma

    Radiologic evaluation of abdominal trauma must provide a quick and accurate assessment of the lesions in order to improve the management of the patient. The technique used varies depending on the mechanism of the trauma (blunt trauma or stab wounds) and the hemodynamic status. Radiologic evaluation is usually performed in blunt trauma whereas stab wound trauma is usually explored surgically. The various techniques available are standard radiographs, ultrasonography, computed tomography and arteriography. The role of magnetic resonance imaging in the immediate evaluation is still not well defined. It appears to be useful method in the delayed evaluation of diaphragmatic trauma. Computed tomography is the method most commonly performed in trauma patients. This technique is accurate and allows correct assessment of the lesions. The disadvantages are the radiation induced and the need for a hemo-dynamically stable patient. The aim of the radiologic evaluation is to provide the clinicians with an accurate description of the lesions. It can help in the management of the patient usually in association with clinical and laboratory data. It can also guide interventional procedures (drainage, embolization...). Finally, it allows radiographic follow-up when conservative treatment is performed. (authors). 26 refs., 11 figs., 1 tab

  18. Young children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS) followed in pediatric gastroenterology (PED-GI) vs primary pediatric care (PED): Differences in outcomes

    The American Academy of Pediatrics suggests that children with recurrent abdominal pain without alarm signs be managed in pediatric rather than specialty care. However, many of these children are seen in tertiary care. In a longitudinal examination of physical and psychological symptoms, we hypothes...

  19. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

    Yu Chen

    2014-01-01

    Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

  20. 腹部恶性肿瘤患者血瘀证检验指标的临床研究%Clinical Study of Blood Stasis Syndrome Detection Index in Patients with Abdominal Malignant Tumor

    高泽峰

    2015-01-01

    Objective:To analyze the distribution characteristics related markers of blood stasis syndrome detection index in patients with abdominal malignant tumor distribution characteristics,putting forward to the countermeasures. Methods:93 cases of patients with abdominal malignant tumor were selected to carry on the correlation index test. Re-sults:The incidence rate of blood stasis syndrome in abdominal malignant tumor group was higher than that in the healthy group. There was statistically significant difference(P<0. 05);PLT(blood platelet)level of patients with early abdominal malignant tumor was higher than that of healthy group,advanced subgroup was higher than that in the late early subgroups;PT level was higher than the subgroup healthy group;TT level of the early subgroup and in the middle and late period was higher than that of healthy group;PSV,HCT level of advanced subgroup was higher than that of the healthy group;PU level of early subgroup was lower than that of the healthy group and the advanced subgroup was lower than that of early subgroup. There was statistically significant difference(P<0. 05). Conclusion:It is the case that blood stasis syndrome proportion of patients with abdominal malignant tumor is higher than the normal,so preventive measures should be actively taken to prevent concurrent thrombotic events.%目的:分析腹部恶性肿瘤患者血瘀证检验指标水平分布特点,总结干预对策。方法:选取腹部恶性肿瘤患者93例,治疗前行相关指标检验。结果:腹部恶性肿瘤组血瘀证发生率高于健康组,差异具有统计学意义( P<0.05);腹部恶性肿瘤患者早期PLT高于健康组,中晚期高于早期,中晚期PT长于健康组,早期与中晚期TT长于健康组,中晚期PSV、HCT长于健康组与早期,早期PU低于健康组,中晚期低于早期,差异具有统计学意义(P<0.05)。结论:腹部恶性肿瘤患者合并血瘀证比重超出正常人,应

  1. Diagnostic accuracy of self-reported symptomatic assessment versus per speculum/per vaginal examination for the diagnosis of vaginal/cervical discharge and lower abdominal pain syndromes among female sex workers

    Kosambiya, Jayendrakumar K.; Baria, H. G.; Parmar, Rohit; Mhaskar, Rahul; Emmanuel, Patricia; Kumar, Ambuj

    2016-01-01

    Background: National AIDS Control Organization guidelines on enhanced syndromic case management of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) require per speculum (P/S) and per vaginal (P/V) examinations for diagnosis of STIs. However, it is not known if the addition of P/S and P/V examinations to self-reported symptomatic assessment adds any value for the diagnosis of STI/RTI. Objective: To assess the diagnostic accuracy of P/S and P/V examinations compared with self-reported symptomatic assessment in a cohort of female sex workers (FSWs). Methods: We performed a cross-sectional study from August 2009 to June 2010, among 519 FSWs in Surat city, Gujarat, India. Symptomatic assessment for the presence or absence of vaginal/cervical discharge (VCD) or lower abdominal pain (LAP) was done using a self-administered questionnaire. After completion of the questionnaire, all participants underwent P/S and P/V examinations. Summary diagnostic accuracy measures were calculated. Results: Five hundred and nineteen FSWs between the ages of 18–49 years participated in the study. The median age of participants was 31 years. The prevalence of VCD and LAP syndromes based on vaginal discharge, LAP, or both was 56%, 5,–10%, respectively. The sensitivity of P/S and P/V examinations depending on symptomatic assessment ranged from 47% to 76%. The specificity ranged from 73% to 93%. The positive predictive value ranged from 25% to 83%, and the negative predictive value ranged from 56% to 98%. Conclusion: Symptomatic assessment alone is not adequate for the diagnosis of VCD and LAP syndromes and can lead to a significant number of missed cases (36%). A P/S and P/V examinations is critical for assessment of VCD and LAP syndromes and subsequent treatment.

  2. Diagnostic accuracy of self-reported symptomatic assessment versus per speculum/per vaginal examination for the diagnosis of vaginal/cervical discharge and lower abdominal pain syndromes among female sex workers

    Jayendrakumar K Kosambiya

    2016-01-01

    Full Text Available Background: National AIDS Control Organization guidelines on enhanced syndromic case management of sexually transmitted infections (STIs and reproductive tract infections (RTIs require per speculum (P/S and per vaginal (P/V examinations for diagnosis of STIs. However, it is not known if the addition of P/S and P/V examinations to self-reported symptomatic assessment adds any value for the diagnosis of STI/RTI. Objective: To assess the diagnostic accuracy of P/S and P/V examinations compared with self-reported symptomatic assessment in a cohort of female sex workers (FSWs. Methods: We performed a cross-sectional study from August 2009 to June 2010, among 519 FSWs in Surat city, Gujarat, India. Symptomatic assessment for the presence or absence of vaginal/cervical discharge (VCD or lower abdominal pain (LAP was done using a self-administered questionnaire. After completion of the questionnaire, all participants underwent P/S and P/V examinations. Summary diagnostic accuracy measures were calculated. Results: Five hundred and nineteen FSWs between the ages of 18–49 years participated in the study. The median age of participants was 31 years. The prevalence of VCD and LAP syndromes based on vaginal discharge, LAP, or both was 56%, 5,–10%, respectively. The sensitivity of P/S and P/V examinations depending on symptomatic assessment ranged from 47% to 76%. The specificity ranged from 73% to 93%. The positive predictive value ranged from 25% to 83%, and the negative predictive value ranged from 56% to 98%. Conclusion: Symptomatic assessment alone is not adequate for the diagnosis of VCD and LAP syndromes and can lead to a significant number of missed cases (36%. A P/S and P/V examinations is critical for assessment of VCD and LAP syndromes and subsequent treatment.

  3. [Surgical criteria for reoperation in abdominal surgery].

    Bricot, R

    1975-07-01

    Analysis of the surgical criteria for reintervention in Abdominal Surgery led to the accentuation of a certain number of pictures of occlusion, general infectious syndromes, postoperative peritonitis, gastro-intestinal fistula and hemorrhagic syndrome. In all cases, the clinical examination can be misleading in particular in the case of peritonitis, and the history and non-surgical criteria must be strongly borne in mind. PMID:2036

  4. Abdominal Pain or Cramping

    ... Body & lifestyle changes > Abdominal pain or cramping Abdominal pain or cramping E-mail to a friend Please ... signs of severe pain. What causes mild belly pain in pregnancy? There are different causes for mild ...

  5. Endovascular vs open repair for ruptured abdominal aortic aneurysm

    Nedeau, April E.; Pomposelli, Frank B.; Hamdan, Allen D.; Wyers, Mark C.; Hsu, Richard; Sachs, Teviah; Siracuse, Jeffrey J.; Schermerhorn, Mark L.

    2014-01-01

    Objective Endovascular repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA) has become first-line therapy at our institution and is performed under a standardized protocol. We compare perioperative mortality, midterm survival, and morbidity after EVAR and open surgical repair (OSR). Methods Records were retrospectively reviewed from May 2000 to September 2010 for repair of infrarenal rAAAs. Primary end points included perioperative mortality and midterm survival. Secondary end points included acute limb ischemia, length of stay, ventilator-dependent respiratory failure, myocardial infarction, renal failure, abdominal compartment syndrome, and secondary intervention. Statistical analysis was performed using the t-test,X2 test, the Fisher exact test, and logistic regression calculations. Midterm survival was assessed with Kaplan-Meier analysis and Cox proportional hazard models. Results Seventy-four infrarenal rAAAs were repaired, 19 by EVAR and 55 by OSR. Despite increased age and comorbidity in the EVAR patients, perioperative mortality was 15.7% for EVAR, which was significantly lower than the 49% for OSR (odds ratio, 0.19; 95% CI, 0.05-0.74; P = .008). Midterm survival also favored EVAR (hazard ratio, 0.40; 95% CI, 0.21-0.77; P = .028, adjusted for age and sex). Mean follow-up was 20 months, and 1-year survival was 60% for EVAR vs 45% for OSR. Mean length of stay for patients surviving >1 day was 10 days for EVAR and 21 days for OSR (P = .004). Ventilator-dependent respiratory failure was 5% in the EVAR group vs 42% for OSR (odds ratio, 0.08; 95% CI, 0.01-0.62; P = .001). Conclusions EVAR of rAAA has a superior perioperative survival advantage and decreased morbidity vs OSR. Although not statistically significant, overall survival favors EVAR. We recommend that EVAR be considered as the first-line treatment of rAAAs and practiced as the standard of care. PMID:22626871

  6. 腹针与神阙灸治疗慢性疲劳综合征临床研究%Clinical Study of Chronic Fatigue Syndrome Treated by Abdominal Acupuncture Combined with Moxibustion at Shenque (CV8)

    高建芸

    2016-01-01

    Objective:To explore the clinical curative effect of abdominal acupuncture combined with moxi-bustion at Shenque(CV8) on treatment of chronic fatigue Ssyndrome. Methods:A total of 80 outpatients in hospitals of Singapore area were randomly divided into abdominal acupuncture combined with moxibustion group of 42 cases and ordinary acupuncture group of 38 cases. Ten sessions were a course of treatment. Af-ter two courses,the curative effects and symptom scores of the two groups were compared. Results:The total effective rate was 92.86% in the abdominal acupuncture combined with moxibustion group and 84.21% in the ordinary acupuncture group,and the difference was statistically significant (P<0.05). The difference of symptom scores before and after treatment was 9.85 ±2.90 in the abdominal acupuncture combined with moxibustion group and 6.46 ±2.27 in the ordinary acupuncture group. The symptoms in the abdominal acupuncture combined with moxibustion group were improved more obviously than those in the ordinary acupuncture group,with significant difference(P<0.01).Conclusion:The clinical curative effect of abdominal acupuncture combined with moxibustion at Shenque(CV8) on treating chronic fatigue syndrome is better than that of the ordinary acupuncture.%目的:探究腹针配合神阙灸法治疗慢性疲劳综合征的临床疗效。方法:收集新加坡地区医院门诊病例80例,随机分为两组,腹针配合神阙灸组42例和常规体针组38例,治疗10次为1个疗程,2个疗程后观察临床疗效、统计治疗前后症状评分进行比较。结果:腹针配合神阙灸组总有效率92.86%,常规体针组为84.21%,差异有统计学意义(P<0.05);腹针配合神阙灸组治疗前后症状评分差值为9.85±2.90,常规体针组治疗前后差值为6.46±2.27,症状改善程度前者优于单纯体针治疗组,差异有统计学意义(P<0.01)。结论:腹针配合神阙灸法治疗慢性疲劳综合征临床

  7. Susceptibility Variants for Waist Size in Relation to Abdominal, Visceral and Hepatic Adiposity in Postmenopausal Women

    Lim, Unhee; Ernst, Thomas; Wilkens, Lynne R.; Albright, Cheryl L.; Lum-Jones, Annette; Seifried, Ann; Buchthal, Steven D.; Novotny, Rachel; Kolonel, Laurence N; Chang, Linda; Cheng, Iona; Le Marchand, Loïc

    2012-01-01

    Genome-wide association studies (GWAS) have identified common genetic variants that may contribute specifically to the risk of abdominal adiposity, as measured by waist circumference or waist-to-hip ratio. However, it is unknown whether these genetic risk factors affect relative body fat distribution in the abdominal visceral and subcutaneous compartments. The association between imaging-based abdominal fat mass and waist size risk variants in the FTO, LEPR, LYPLAL1, MSRA, NRXN3, and TFAP2B g...

  8. Dual-Compartment Inflatable Suitlock

    Kennedy, Kriss J.; Guirgis, Peggy L.; Boyle, Robert M.

    2013-01-01

    There is a need for an improvement over current NASA Extravehicular Activity (EVA) technology. The technology must allow the capacity for quicker, more efficient egress/ingress, allow for shirtsleeve suit maintenance, be compact in transport, and be applicable to environments ranging from planetary surface (partial-g) to orbital or deep space zero-g environments. The technology must also be resistant to dust and other foreign contaminants that may be present on or around a planetary surface. The technology should be portable, and be capable of docking with a variety of habitats, ports, stations, vehicles, and other pressurized modules. The Dual-Compartment Inflatable Suitlock (DCIS) consists of three hard inline bulkheads, separating two cylindrical membrane-walled compartments. The Inner Bulkhead can be fitted with a variety of hatch types, docking flanges, and mating hardware, such as the Common Berthing Mechanism (CBM), for the purpose of mating with vehicles, habitats, and other pressurized modules. The Inner Bulkhead and Center Bulkhead function as the end walls of the Inner Compartment, which during operations, would stay pressurized, either matching the pressure of the habitat or acting as a lower-pressure transitional volume. The Inner Compartment contains donning/doffing fixtures and inner suit-port hatches. The Center Bulkhead has two integrated suit-ports along with a maintenance hatch. The Center Bulkhead and Outer Bulkhead function as the end walls of the Outer Compartment, which stays at vacuum during normal operations. This allows the crewmember to quickly don a suit, and egress the suitlock without waiting for the Outer Compartment to depressurize. The Outer Compartment can be pressurized infrequently for both nominal and off-nominal suit maintenance tasks, allowing shirtsleeve inspections and maintenance/repair of the environmental suits. The Outer Bulkhead has a pressure-assisted hatch door that stays open and stowed during EVA operations, but can

  9. Rapunzel syndrome

    An 18-year-old single female patient, presented with non specific gastrointestinal symptoms of anorexia, abdominal pain, and change in bowel habit. Clinically she was anemic, cachectic, and depressed. Abdominal examination revealed mobile epigastric mass. The scalp alopecia and endoscopy coupled by computed tomography scan, confirmed the diagnoses of trichobezoar, but it was not diagnosed as Rapunzel syndrome except after laparotomy, gastrotomy, and enterotomy. There are less than 16 cases of Rapunzel syndrome described worldwide, and this is the first case to be described in the middle east. (author)

  10. Factors associated with abdominal obesity in children

    Matheus Ribeiro Theodósio Fernandes Melzer

    2015-12-01

    Full Text Available Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998 and Taylor et al. (2000 were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3, female gender (OR=4.1; 95%CI 1.8-9.3 and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0 were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children.

  11. Impaired Preadipocyte Differentiation Into Adipocytes in Subcutaneous Abdominal Adipose of PCOS-Like Female Rhesus Monkeys

    Keller, Erica; Chazenbalk, Gregorio D.; Aguilera, Paul; Madrigal, Vanessa; Grogan, Tristan; Elashoff, David; Daniel A Dumesic; David H Abbott

    2014-01-01

    Metabolic characteristics of polycystic ovary syndrome women and polycystic ovary syndrome-like, prenatally androgenized (PA) female monkeys worsen with age, with altered adipogenesis of sc abdominal adipose potentially contributing to age-related adverse effects on metabolism. This study examines whether adipocyte morphology and gene expression in sc abdominal adipose differ between late reproductive-aged PA female rhesus monkeys compared with age-matched controls (C). Subcutaneous abdominal...

  12. Functional Abdominal Pain: "Get" the Function, Loose the Pain.

    Draeger-Muenke, Reinhild

    2015-07-01

    Functional abdominal pain is a mind-body, psychosocial, and self-reinforcing experience with significant consequences for the sufferer and the surrounding support network. The occurrence of unpredictable symptoms and their severity add an element of dread and feeling out-of-control to daily life and often reduce overall functioning in a downward spiral. Two clinical presentations of functional abdominal pain are offered in this article (composites to protect confidentiality) dealing with abdominal pain syndrome and abdominal migraines. The treatment demonstrates the use of hypnotic principles for self-regulation, exploration, and meaning-making. Hypnosis treatment is conducted in combination with mindfulness-based interventions and Traditional Chinese Medicine's (TCM) teachings regarding abdominal health and illness. The clinical examples illustrate medical findings that suggest children with early life stress and an early onset of gastrointestinal somatization may not simply outgrow their functional abdominal pain but may suffer into adulthood. PMID:26046716

  13. Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry

    Ayumi Ido; Yuki Nakayama; Kojiro Ishii; Motoyuki Iemitsu; Koji Sato; Masahiro Fujimoto; Toshiyuki Kurihara; Takafumi Hamaoka; Noriko Satoh-Asahara; Kiyoshi Sanada

    2015-01-01

    Sarcopenia has never been diagnosed based on site-specific muscle loss, and little is known about the relationship between site-specific muscle loss and metabolic syndrome (MetS) risk factors. To this end, this cross-sectional study aimed to investigate the relationship between site-specific muscle size and MetS risk factors. Subjects were 38 obese men and women aged 40-82 years. Total body fat and lean body mass were assessed by whole-body dual-energy X-ray absorptiometry (DXA) scan. Muscle ...

  14. Abdominal MRI in childhood

    MRI provides diagnostic information in multiple abdominal diseases in childhood. Additional information to sonographic findings can be achieved in the diagnosis of abdominal malformation as well as in several inflammatory processes. In childhood cancer imaging MRI is essential at the beginning as well as during therapy to assess response to therapy. Because of radiation protection MRI has to replace CT in abdominal imaging in children. Some technical details have to be considered when children are examined. (orig.)

  15. Abdominal cavity exploration with kinetic scintimaging

    Nuclear medicine procedures are being utilized in an increasing variety and number of intra-abdominal clinical problems. These non-invasive intra-abdominal exploratory scintimaging procedures are often dynamic or kinetic in nature, i.e. revealing primarily functional information even to the point of employing adjunctive drugs and multiple simultaneous radiotracers. The advent of correlative non-invasive diagnostic imaging modalities has thus far largely complemented abdominal nuclear medicine procedures. The luminal gastro-intestinal tract has yielded to investigation with radiotracers with procedures now widely employed to study gastric function, gastro-oesophagal reflux and intestinal bleeding. The role of hepatic and splenic reticuloendethelial compartment imaging has been strengthened by increased dependability, and remains as the first line screening test for a variety of suspected intrahepatic lesions, especially neoplasia. The recent introduction of improved hepatobiliary radiotracers, mostly iminodiacetic acid derivatives, has considerably expanded the scope of diagnostic investigations of the liver, especially in problems of jaundice and acute cholecystitis. Pancreatic imaging continues to be a disappointment and at best is only adjunctive to correlative imaging procedures. Some hope may be seen in the recent reports of successful pancreatic imaging with positron emission tomography utilizing labelled amino-acid derivatives. Diffuse abdominal processes, especially abcesses and suspected infection, have been efficaciously approached with 67Ga citrate and also, more recently, 111-In-labelled leucocytes. Many of these advances and applications have also been readily applicable to pediatric problems. (author)

  16. [Abdominal pregnancy, institutional experience].

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy. PMID:9737070

  17. Imaging in abdominal trauma

    Imaging in abdominal trauma with special regard to the value of abdominal X-ray, ultrasound and computed tomography is described. The introduction to each organ focusses on the clinical situation, special mechanism of trauma, symptoms and the pathological staging of trauma. (orig.)

  18. Non-contact diagnostic system for sleep apnea-hypopnea syndrome based on amplitude and phase analysis of thoracic and abdominal Doppler radars.

    Kagawa, Masayuki; Tojima, Hirokazu; Matsui, Takemi

    2016-05-01

    Full-night polysomnography (PSG) has been recognized as the gold standard test for sleep apnea-hypopnea syndrome (SAHS). However, PSG examinees are physically restrained for the full night by many contact sensors and obtrusive connecting cables, inducing mental stress. We developed a non-contact SAHS diagnostic system that can detect apneic events without inducing stress in monitored individuals. Two Doppler radars were installed beneath the mattress to measure the vibrations of the chest and abdomen, respectively. Our system determines apnea and hypopnea events when the radar output amplitude decreases by PSG than with pulse oximetry (r = 89 %). When predicting the severity of SAHS with an apnea-hypopnea index (AHI) of >15/h or >30/h using PSG as a reference, the radar system achieved a sensitivity of 96 and 90 %, and a specificity of 100 and 79 % with an AHI of >15/h and >30/h, respectively. The proposed radar system can be used as an alternative to the current airflow sensor, and to chest and abdomen belts for apnea-hypopnea evaluation. PMID:26307200

  19. Abdominal tuberculosis, clinical-radiological revision

    We retrospectively evaluated the clinical charts and diagnostic images of hospitalised patients with histological or bacteriologic demonstration of abdominal tuberculosis (TB) including those with probable abdominal TB, who had pulmonary TB and radiologic findings highly suggestive of abdominal TB with favourable response to treatment. Cases with genitourinary TB were excluded. We found 24 patients with an average age of 25 yrs. In some cases this entity was not suspected on the imaging studies, and diagnosis was made on surgery. The most frequent symptoms were: abdominal pain, diarrhoea, fever, vomiting, weight loss and abdominal mass. Active pulmonary TB was demonstrated on 8 cases (33%) Peritoneal presentation was the most frequent (54%) with septated or simple ascites, cystic ascites or pseudocysts within bowel loops. Mesenteric involvement (21 %) showed adenopathy or masses identified with CT. Intestinal forms (17%) showed pseudo-polyps on terminal ileum and ulcers on ileum, cecum and colon. We found one case with diffuse ulcerative involvement of the colon. Two cases showed hepatic involvement, one with an abscess and a tuberculosis Cole cystitis, with pyloric syndrome due to fibrosis

  20. Celiac Artery Compression Syndrome

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  1. Persistent Organic Pollutants in Serum and Several Different Fat Compartments in Humans

    George W. Yu

    2011-01-01

    Full Text Available Background. Chemicals that store in lipid-rich compartments have the potential for long-term disruption of metabolic and endocrine processes. Given the evidence that persistent organic pollutants (POPs also alter systemic metabolic, endocrine, and immune system functions, it follows that elevated chemical concentrations in intra-abdominal fat may alter function, through local chemical signaling, of visceral organs. Despite this potential, there has been little study defining POP concentrations in live human intra-abdominal fat. It is at present uncertain whether POPs distribute equally to all fat compartments, including fat in serum. Methods. Seven human subjects scheduled for elective surgery for benign lesions or cancer provided consent for removal of samples of subcutaneous and intra-abdominal fat and/or cancerous tissue. These samples were analyzed for 22 chlorinated pesticides and 10 polychlorinated biphenyl (PCB congeners by GC/ECD plus GC/MS. Results. In only two subjects were the patterns and relative concentrations of PCBs and pesticides about the same in all fat compartments. In the other subjects, there were major differences in levels in subcutaneous as compared to other compartments, but with some higher and some lower. While the pattern of PCBs in the various compartments matched that of the pesticides in some, it was opposite in others. Interpretation. These results demonstrate a complicated distribution of PCB congeners and pesticides in various lipid compartments. The difference may reflect various Kows, different rates of metabolism, and/or different lengths of exposure. But the results suggest that contaminant levels in serum or even subcutaneous fat do not necessarily indicate concentrations and patterns in other kinds of adipose tissue.

  2. Compartment model DETRA for Windows

    The computer code DETRA is a generic tool for environmental transfer analyses of radioactive or stable substances. The code has been applied for various purposes, mainly problems related to the biospheric transfer of radionuclides both in safety analyses of disposal of nuclear wastes and in consideration of foodchain exposure pathways in the analyses of off-site consequences of reactor accidents. The first computer code version for Windows interface environment of the modernized DETRA compartment model is developed in the study. As the model needs quite a large number of input data for specifying a calculation case, different segments of the input file (nuclide chains, compartments, time grid, source term, initial values, applications for multi-sequence calculations, printout specifications) are presented in their own window displays. The basic character of the code allows the user to specify the compartment model structure suitable for each considered environmental transport problem individually. The transport of radionuclides can be considered in several cases: water courses and related food chains, soil surface layers, food chains and general food stuffs, body burden analyses, etc. The pre-fined and saved input files for different areas of environmental, transport problems are also available for the user. The starting point for the analysis can be deposition on ground, or source term of radionuclides from e.g. surface soil into a recipient can be considered by the code as well

  3. Numerical treatment of compartment models

    This report describes and interactive program RADIO (Radioactive Decay Information Online) for studying the radioactive decay process, with applications to many ecological problems, but not necessarily involving radioactive processes. Starting with the compartment coefficients and initial values of the various compartments the problem is solved as a system of linear ordinary differential equations. The method of solution is the direct use of matrix exponentials or the backward differences method. A program INVERS is also available for the solution of the inverse problem, that is parameter estimation in a system of linear ordinary differential equations when the solution is available pointwise. The output can be printed on a line printer either from a result file or from the plot file, which of course also can be used to produce graphic output. The plot file is processed by the plotting program VISION or by the auxiliary printing program RADAR. Another file can be used for a later restart from the point of time where the previous computation was aborted or from an arbitrary point of time if the relevant starting information is available. This is useful in order to avoid the manual input of a compartment matrix if it is similar to one used before. When the program RADIO is run the user answers to the question asked by the program. The programs are written in Fortran 77 for the Digital Equipment VAX 11 with graphical presentation on a Tektronix 4010, and are available from the author. (Author)

  4. Compartment models in radiation protection

    Full text: This paper presents a brief review of the use of compartment models in radiation protection. These models are widely used for modelling the transport of radionuclides in plants, crops, man and animals. Special models are used for the human respiratory tract, gastro-intestinal tract and skeleton, and for particular radionuclides (e.g. transport of strontium, caesium and iodine in sheep and cattle) or groups of radionuclides (e.g. the actinides). Compartment models are also used for assessing the effects of intakes of radionuclides by man in the natural environment, in the workplace, as a result of medical treatment, or as a result of planned or accidental releases of radionuclides to the environment. They are also used for modelling the transport of radionuclides in rivers, estuaries and enclosed seas. Examples of compartment models currently used for some of these applications are presented, and their limitations are discussed. The methods and assumptions used in solving the equations associated with these models are briefly discussed, with particular reference to the problem of assessing the effects of intakes of radionuclides by man

  5. Abdominal pain and hyperamylasaemia—not always pancreatitis

    Slack, Sally; Abbey, Ianthe; Smith, Dominic

    2010-01-01

    A raised serum amylase concentration, at least four times the upper limit of normal (ULN), is used to support the diagnosis of acute pancreatitis in a patient presenting with abdominal pain. The authors report a case of toxic shock syndrome complicated by a raised serum amylase concentration that peaked at 50 times the ULN in a patient with recurrent abdominal pain. The commonest cause of hyperamylasaemia is pancreatic; however, further investigation of serum lipase and amylase isoenzyme stud...

  6. Nutcracker syndrome

    Purpose: The purpose of this case study is to highlight the symptoms of the Nutcracker Syndrome (NCS), the methods of clinical investigations and the importance of differential diagnosis. Introduction: The NCS refers to left renal vein entrapment caused by abnormal branching patterns of the superior mesenteric artery from the aorta.1,2 Clinical case presentation: A 27 years old female presented to the emergency department with complaints of abdominal discomfort, bloating, loose bowel motions and irregular micro-haematuria. The radiologist's report indicated the findings from computed tomography examination to be consistent with anterior NCS. Discussion: In most of the NCS cases the clinical symptoms are non-specific.3 The syndrome is caused by a vascular disorder, but its clinical manifestation can relate to a wide range of abdominal, urological, endovascular or gynaecological pathologies.4 Conclusion: Nutcracker Syndrome is a relatively rare disease and underdiagnosed may lead to left renal vein thrombosis

  7. 36 CFR 1192.127 - Sleeping compartments.

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Sleeping compartments. 1192.127 Section 1192.127 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS... Intercity Rail Cars and Systems § 1192.127 Sleeping compartments. (a) Sleeping compartments required to...

  8. 49 CFR 38.127 - Sleeping compartments.

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Sleeping compartments. 38.127 Section 38.127... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Intercity Rail Cars and Systems § 38.127 Sleeping compartments. (a) Sleeping compartments required to be accessible shall be designed so as to allow a person using...

  9. Abdominal ultrasound (image)

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X- ... use high frequency sound waves to produce an image and do not expose the individual to radiation. ...

  10. Abdominal CT scan

    Computed tomography scan - abdomen; CT scan - abdomen; CAT scan - abdomen; CT abdomen and pelvis ... An abdominal CT scan makes detailed pictures of the structures inside your belly (abdomen) very quickly. This test may be used to ...

  11. Abdominal tuberculosis: Imaging features

    Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis

  12. Imaging in Tuberculosis abdominal

    In this article we illustrate and discuss imaging features resulting from Tuberculosis abdominal affectation. We present patients evaluated with several imaging modalities who had abdominal symptoms and findings suggestive of granulomatous disease. Diagnosis was confirm including hystopatology and clinical outgoing. Cases involved presented many affected organs such as lymphatic system, peritoneum, liver, spleen, pancreas, kidneys, ureters, adrenal glands and pelvic organs Tuberculosis, Tuberculosis renal, Tuberculosis hepatic, Tuberculosis splenic Tomography, x-ray, computed

  13. Stochastic Calculus of Wrapped Compartments

    Coppo, Mario; Drocco, Maurizio; Grassi, Elena; Troina, Angelo; 10.4204/EPTCS.28.6

    2010-01-01

    The Calculus of Wrapped Compartments (CWC) is a variant of the Calculus of Looping Sequences (CLS). While keeping the same expressiveness, CWC strongly simplifies the development of automatic tools for the analysis of biological systems. The main simplification consists in the removal of the sequencing operator, thus lightening the formal treatment of the patterns to be matched in a term (whose complexity in CLS is strongly affected by the variables matching in the sequences). We define a stochastic semantics for this new calculus. As an application we model the interaction between macrophages and apoptotic neutrophils and a mechanism of gene regulation in E.Coli.

  14. Persistent Organic Pollutants in Serum and Several Different Fat Compartments in Humans

    George W. Yu; John Laseter; Charles Mylander

    2011-01-01

    Background. Chemicals that store in lipid-rich compartments have the potential for long-term disruption of metabolic and endocrine processes. Given the evidence that persistent organic pollutants (POPs) also alter systemic metabolic, endocrine, and immune system functions, it follows that elevated chemical concentrations in intra-abdominal fat may alter function, through local chemical signaling, of visceral organs. Despite this potential, there has been little study defining POP concentratio...

  15. Mechanical ventilation and intra-abdominal hypertension: 'Beyond Good and Evil'

    Pelosi, Paolo; Vargas, Maria

    2012-01-01

    Intra-abdominal hypertension is frequent in surgical and medical critically ill patients. Intra-abdominal hypertension has a serious impact on the function of respiratory as well as peripheral organs. In the presence of alveolar capillary damage, which occurs in acute respiratory distress syndrome (ARDS), intra-abdominal hypertension promotes lung injury as well as edema, impedes the pulmonary lymphatic drainage, and increases intra-thoracic pressures, leading to atelectasis, airway closure, ...

  16. Abdominal Dual Energy Imaging

    Sommer, F. Graham; Brody, William R.; Cassel, Douglas M.; Macovski, Albert

    1981-11-01

    Dual energy scanned projection radiography of the abdomen has been performed using an experimental line-scanned radiographic system. Digital images simultaneously obtained at 85 and 135 kVp are combined, using photoelectric/Compton decomposition algorithms to create images from which selected materials are cancelled. Soft tissue cancellation images have proved most useful in various abdominal imaging applications, largely due to the elimination of obscuring high-contrast bowel gas shadows. These techniques have been successfully applied to intravenous pyelography, oral cholecystography, intravenous abdominal arteriog-raphy and the imaging of renal calculi.

  17. Childhood abdominal cystic lymphangioma

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)

    2002-02-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  18. Childhood abdominal cystic lymphangioma

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two. Conclusions: US

  19. Abdominal Vascular Catastrophes.

    Singh, Manpreet; Koyfman, Alex; Martinez, Joseph P

    2016-05-01

    Abdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained. A multidisciplinary approach is required to have a positive impact on mortality rates. Ruptured abdominal aortic aneurysm likewise may present in a cryptic fashion. A specific type of ruptured aneurysm, the aortoenteric fistula, often masquerades as the more common routine gastrointestinal bleed. The astute clinician recognizes that this is a more lethal variant of gastrointestinal hemorrhage. PMID:27133247

  20. Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage

    Papavramidis Theodossis S

    2009-06-01

    Full Text Available Abstract Background Acute pancreatitis leads to abdominal hypertension and compartment syndrome. Weeks after the episodes pancreatic fluids sometimes organize to pseudocysts, fluid collections by or in the gland. Aims of the present study were to evaluate the intra-abdominal pressure (IAP induced by large pancreatic pseudocysts and to examine the effect of their transcutaneous drainage on IAP. Methods Twenty seven patients with a pancreatic pseudocyst were included. Nine patients with pseudocysts greater than 1l (group A had CT drainage and eighteen (volume less than 1l were the control group. The measurements of group A were taken 6 hours before and every morning after the drainage, while for group B, two measurements were performed, one at the day of the initial CT and one 7 days after. Abdominal compliance (Cabd was calculated. Data were analyzed using student's t-test. Results Baseline IAP for group A was 9.3 mmHg (S.D. 1.7 mmHg, while the first post-drainage day (PDD IAP was 5.1 mmHg (S.D. 0.7 mmHg. The second PDD IAP was 5.6 mmHg (S.D. 0.8 mmHg, the third 6.4 mmH (S.D. 1.2 mmHgg, the fourth 6.9 mmHg (S.D. 1.6 mmHg, the fifth 7.9 mmHg (S.D. 1.5 mmHg, the sixth 8.2 mmHg (S.D. 1.4 mmHg, and the seventh 8.2 mmHg (S.D. 1.5 mmHg. Group B had baseline IAP 8.0 mmHg (S.D. 1.2 mmHg and final 8.2 mmHg (S.D. 1.4 mmHg. Cabd after drainage was 185.6 ml/mmHg (SD 47.5 ml/mmHg. IAP values were reduced between the baseline and all the post-drainage measurements in group A. IAPs seem to stabilize after the 5th post-drainage day. Baseline IAP was higher in group A than in group B, while the two values, at day 7, were equivalent. Conclusion The drainage of large pancreatic pseudocyst reduces IAP. Moreover, the IAP seems to rise shortly after the drainage again, but in a way that it remains inferior to the initial value. More chronic changes to the IAP are related to abdominal cavity's properties and have to be further studied.

  1. Hybrid Calculus of Wrapped Compartments

    Coppo, Mario; Drocco, Maurizio; Grassi, Elena; Sciacca, Eva; Spinella, Salvatore; Troina, Angelo; 10.4204/EPTCS.40.8

    2010-01-01

    The modelling and analysis of biological systems has deep roots in Mathematics, specifically in the field of ordinary differential equations (ODEs). Alternative approaches based on formal calculi, often derived from process algebras or term rewriting systems, provide a quite complementary way to analyze the behaviour of biological systems. These calculi allow to cope in a natural way with notions like compartments and membranes, which are not easy (sometimes impossible) to handle with purely numerical approaches, and are often based on stochastic simulation methods. Recently, it has also become evident that stochastic effects in regulatory networks play a crucial role in the analysis of such systems. Actually, in many situations it is necessary to use stochastic models. For example when the system to be described is based on the interaction of few molecules, when we are at the presence of a chemical instability, or when we want to simulate the functioning of a pool of entities whose compartmentalised structur...

  2. Severe fat embolism in perioperative abdominal liposuction and fat grafting

    Rodrigo de Lima e Souza; Bruno Tavares Apgaua; João Daniel Milhomens; Francisco Tadeu Motta Albuquerque; Luiz Antônio Carneiro; Márcio Henrique Mendes; Tiago Carvalho Garcia; Clerisson Paiva; Felipe Ladeia; Deiler Célio Jeunon

    2016-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: Fat embolism syndrome may occur in patients suffering from multiple trauma (long bone fractures) or plastic surgery (liposuction), compromising the circulatory, respiratory and/or central nervous systems. This report shows the evolution of severe fat embolism syndrome after liposuction and fat grafting. CASE REPORT: SSS, 42 years old, ASA 1, no risk factors for thrombosis, candidate for abdominal liposuction and breast implant prosthesis. Subjected to b...

  3. Anatomic Landmarks for the First Dorsal Compartment

    Hazani, Ron; Engineer, Nitin J.; Cooney, Damon; Wilhelmi, Bradon J.

    2009-01-01

    Objective: Knowledge of anatomic landmarks for the first dorsal compartment can assist clinicians with management of de Quervain's disease. The radial styloid, the scaphoid tubercle, and Lister's tubercle can be used as superficial landmarks for the first dorsal compartment. Methods: Thirty-two cadaveric wrists were dissected, and measurements were taken from the predetermined landmarks to the extensor retinaculum. The compartments were also inspected for variability of the abductor pollicis ...

  4. Endometriosis Abdominal wall

    Endometriosis of abdominal wall is a rare entity wi ch frequently appears after gynecological surgery. Case history includes three cases of parietal endometriosis wi ch were treated in Maciel Hospital of Montevideo. The report refers to etiological diagnostic aspects and highlights the importance of total resection in order to achieve definitive healing

  5. Adult abdominal hernias.

    Murphy, Kevin P

    2014-06-01

    Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.

  6. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the abdomen ... limitations of Abdominal Ultrasound Imaging? What is Abdominal Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  7. Marfan syndrome.

    Jain, Eesha; Pandey, Ramesh Kumar

    1997-01-01

    Marfan syndrome is a rare autosomal dominant disorder of the connective tissue, with skeletal, ligamentous, orooculofacial, pulmonary, abdominal, neurological and the most fatal, cardiovascular manifestations. It has no cure but early diagnosis, regular monitoring and preventive lifestyle regimen ensure a good prognosis. However, the diagnosis can be difficult as it is essentially a clinical one, relying on family history, meticulous physical examination and investigation of involved organ sy...

  8. The metabolic syndrome in HIV

    Worm, Signe W; Lundgren, Jens D

    2011-01-01

    The metabolic syndrome (MS) is a term used to describe the clustering of risk factors for cardiovascular disease (CVD), including elevated triglyceride (TG), low high density lipoprotein cholesterol (HDL), hypertension, hyperglycemia/ insulin resistance and intra-abdominal obesity. This paper...

  9. Effects of combustible stacking in large compartments

    Gentili, Filippo; Giuliani, Luisa; Bontempi, Franco

    2013-01-01

    This paper focuses on the modelling of fire in case of various distributions of combustible materials in a large compartment. Large compartments often represent a challenge for structural fire safety, because of lack of prescriptive rules to follow and difficulties of taking into account the effect...

  10. Component separation in abdominal trauma.

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

  11. CT of abdominal trauma

    Soon after it became available for clinical use, cranial CT became the method of choice for evaluating head trauma. Only relatively recently have newer generation full-body scanners been installed at major trauma centers, but experience is rapidly being gained in the utilization of CT for abdominal trauma. CT has proved highly accurate in diagnosing a wide variety of injuries to both intra- and retroperitoneal organs in pediatric and adult patient populations. The impact has been evident not only in decreasing utilization of other diagnostic tests, such as angiography, but also in practical management decisions, such as whether to perform exploratory laparotomy. This chapter details the authors' approach to evaluation of abdominal trauma by CT

  12. The blunt abdominal trauma

    Up to 1970 the number of patients suffering from blunt abdominal trauma showed a substantial increase. In more than 50% of all cases there are additional injuries. The most important factor influencing the prognosis of these patients is the early and correct indication for operation and the avoidance of unnecessary laparotomies. As a primary aim in diagnosis one should consider the recognition of an intraperitoneal bleeding without risk for the patient. Peritoneal lavage as an invasive method with low complication rates has proved good. First reports also show good results using the sonography of the abdomen. The recognition of the injured organ allows a carefully directed operation. Concerning the prognosis it is of minor importance. The diagnosis in patients with blunt abdominal trauma at the university clinic of Freiburg consists of: sonography, followed in positive cases by laparotomy or angiography and laparotomy. In cases with questionable results a lavage is done. (orig.)

  13. Abdominal aortic aneurysm surgery

    Gefke, K; Schroeder, T V; Thisted, B; Olsen, P S; Perko, M J; Agerskov, Kim; Røder, O; Lorentzen, Jørgen Ewald

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 55......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems.......The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553...

  14. The abdominal circulatory pump.

    Andrea Aliverti

    Full Text Available Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume shifted between trunk and extremities (Vbs is the difference between changes in trunk and body volume. This is so because both trunk and body volume change identically with breathing and gas expansion or compression. During tidal breathing Vbs was 50-75 ml with an ejection fraction of 4-6% and an output of 750-1500 ml/min. Step increases in abdominal pressure resulted in rapid emptying presumably from the liver with a time constant of 0.61+/-0.1SE sec. followed by slower flow from non-hepatic viscera. The filling time constant was 0.57+/-0.09SE sec. Splanchnic emptying shifted up to 650 ml blood. With emptying, the increased hepatic vein flow increases the blood pressure at its entry into the inferior vena cava (IVC and abolishes the pressure gradient producing flow between the femoral vein and the IVC inducing blood pooling in the legs. The findings are important for exercise because the larger the Vbs the greater the perfusion of locomotor muscles. During asystolic cardiac arrest we calculate that appropriate timing of abdominal compression could produce an output of 6 L/min. so that the abdominal circulatory pump might act as an auxiliary heart.

  15. The Abdominal Circulatory Pump

    Andrea Aliverti; Dario Bovio; Irene Fullin; Dellacà, Raffaele L.; Antonella Lo Mauro; Antonio Pedotti; Macklem, Peter T.

    2009-01-01

    Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume shifted between trunk and extremities (Vbs) is the difference between changes in trunk ...

  16. Obesity-Associated Abdominal Elephantiasis

    Ritesh Kohli

    2013-01-01

    Full Text Available Abdominal elephantiasis is a rare entity. Abdominal elephantiasis is an uncommon, but deformative and progressive cutaneous disease caused by chronic lymphedema and recurrent streptococcal or Staphylococcus infections of the abdominal wall. We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain. The abdominal wall and legs were edematous, with cobblestone-like, thickened, hyperpigmented, and fissured plaques on the abdomen. Two patients had localised areas of skin erythema, tenderness, and increased warmth. There was purulent drainage from the abdominal wall in one patient. They were managed with antibiotics with some initial improvement. Meticulous skin care and local keratolytic treatment for the lesions were initiated with limited success due to their late presentation. All three patients refused surgical therapy. Conclusion. Early diagnosis is important for the treatment of abdominal elephantiasis and prevention of complications.

  17. Abdominal aspergillosis: CT findings

    Yeom, Suk Keu, E-mail: pagoda20@hanmail.net [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: kimhyejin@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: jhbyun@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: aykim@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: mglee@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: hkha@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)

    2011-03-15

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  18. Abdominal aspergillosis: CT findings

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  19. Superior Mesenteric Artery Syndrome or Wilkie Syndrome

    We described three cases of superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, chronic duodenal ileus, or cast syndrome. This syndrome occurs when the third portion of the duodenum is compressed between the SMA and the aorta. The major risk factors for development of SMA syndrome are rapid weight loss and surgical correction of spinal deformities. The clinical presentation of SMA syndrome is variable and nonspecific, including nausea, vomiting, abdominal pain, and weight loss. The diagnosis is based on endoscopic, radiographic and tomographic findings of duodenal compression by the SMA. The treatment of SMA syndrome is aimed at the precipitating factor, which usually is related to weight loss. Therefore, conservative therapy with nutritional supplementation is the initial approach, and surgery is reserved for those who do not respond to nutritional therapy.

  20. Obstruction of Vena Cava and Collateral Flow after Abdominal Reconstruction for Gastroschisis

    Wenceslao M. Calonge, MD

    2015-02-01

    Full Text Available Summary: The upper limit of intra-abdominal pressure after closure of gastroschisis has been suggested around 20 mm Hg. An acute abdominal compartmental syndrome may produce intestinal ischemia with perforation and hepatic or renal failure. We present a case of a baby born with gastroschisis and ileal atresias 2 decades ago. The closure of the defect entailed a borderline abdominal compartmental syndrome with caval occlusion and development of collateral venous circulation. This was evidenced by a phlebographic study at the age of 8. At the age of 19, the patient continued to show a superficial, varicose net and some aesthetic concerns. This minor condition seems not previously reported. The authors intend to raise awareness about current methods for indirect assessment of intra-abdominal pressure when performing abdominal reconstruction for a gastroschisis defect.

  1. Risk factors of thrombosis in abdominal veins

    Amit Kumar Durra; Ashok Chacko; Biju George; Joseph Anjilivelil Joseph; Sukesh Chandran Nair; Vikram Mathews

    2008-01-01

    AIM: To estimate the prevalence of inherited and acquired thrombophilic risk factors in patients with abdominal venous thrombosis and to compare the risk factor profiles between Budd-Chiari syndromes (BCS) and splanchnic vein thrombosis (SVT).METHODS: In this retrospective study, 36 patients with abdominal venous thrombosis were studied.The patients were divided into Budd-Chiari group (hepatic vein, IVC thrombosis) and splanchnic venous thrombosis group (portal, splenic, superior mesenteric veins) based on the veins involved. Hereditary and acquired thrombophilic risk factors were evaluated in all patients.RESULTS: Twenty patients had SVT, 14 had BCS,and 2 had mixed venous thrombosis. Ten patients (28%) had hereditary and 10 patients (28%) acquired thrombophilic risk factors. The acquired risk factors were significantly more common in the SVT group (SVT vs BCS:45% vs 7%,x2=5.7,P=0.02) while hereditary risk factors did not show significant differences between the two groups (SVT vs BCS: 25%vs 36%, x2=0.46,P=0.7). Multiple risk factors were present in one (7%) patient with BCS and in 3 patients (15%) with SVT. No risk factors were identified in 57% of patients with BCS and in 45% of patients with SVT.CONCLUSION: Hereditary and acquired risk factors play an important role in the etiopathogenesis of abdominal venous thrombosis. Acquired risk factors are significantly more common in SVT patients while hereditary factors are similar in both groups.

  2. Compartment models of radioiodine in man

    The differential equations governing the flow of iodine through a three-compartment model of iodine metabolism in man have been solved and the solutions compared to those obtained from two-compartment models. The boundary conditions used were those appropriate for a single acute exposure to radioiodine. The urinary excretion equation derived from the solutions to the three-compartment model exhibits a minimum at four days after the exposure time. This minimum can be used to calculate a maximum value for thyroid burden using a single urinary excretion rate measurement, and in conjunction with this value, an optimum urinary sampling frequency for the different radioiodines can be calculated. (author)

  3. A Spatial Calculus of Wrapped Compartments

    Bioglio, Livio; Coppo, Mario; Damiani, Ferruccio; Sciacca, Eva; Spinella, Salvatore; Troina, Angelo

    2011-01-01

    The Calculus of Wrapped Compartments (CWC) is a recently proposed modelling language for the representation and simulation of biological systems behaviour. Although CWC has no explicit structure modelling a spatial geometry, its compartment labelling feature can be exploited to model various examples of spatial interactions in a natural way. However, specifying large networks of compartments may require a long modelling phase. In this work we present a surface language for CWC that provides basic constructs for modelling spatial interactions. These constructs can be compiled away to obtain a standard CWC model, thus exploiting the existing CWC simulation tool. A case study concerning the modelling of Arbuscular Mychorrizal fungi growth is discussed.

  4. Relação entre obesidade e síndrome metabólica em adolescentes de 10 a 14 anos com obesidade abdominal - DOI: 10.4025/actascihealthsci.v31i2.6194 The relationship between obesity and metabolic syndrome in adolescents between ages 10 and 14, with abdominal obesity - DOI: 10.4025/actascihealthsci.v31i2.6194

    Francisco Martins Silva

    2009-09-01

    Full Text Available Os objetivos do presente estudo foram analisar a relação entre a obesidade e a síndrome metabólica (SM; identificar a prevalência da SM; classificar o estado nutricional e comparar as variáveis: triglicérides, HDL-c, pressão arterial e glicose em adolescentes com obesidade abdominal. A amostra foi constituída por 393 adolescentes de ambos os sexos entre dez e 14 anos de idade. Foram feitas medidas de circunferência do abdômen, aferição da pressão arterial e exames laboratoriais de glicose, colesterol HDL-c e triglicérides. Os resultados apresentaram que, na condição nutricional, o sexo masculino apresentou obesidade de 27,1%, sobrepeso de 4,3 e 68,6% de peso normal. Quanto ao sexo feminino, 29,5% estão com peso normal, 1,6%, com sobrepeso e 68,9%, com obesidade. A obesidade no sexo feminino foi estatisticamente maior do que no masculino. A prevalência de SM foi de 37%, e os meninos tiveram a prevalência maior da síndrome metabólica. Não foi encontrada diferença estatística entre os sexos nas variáveis: triglicérides, HDL-c e pressão arterial. Concluímos que a obesidade foi fator determinante para a SM em adolescentes do sexo feminino, a prevalência da SM e a de obesidade foram altas e nos parâmetros bioquímicos não foi encontrada nenhuma diferença estatística entre os sexos.The objectives of this study were: to analyze the relationship between obesity and metabolic syndrome (MS; identify the prevalence of MS; classify the nutritional condition; and compare the variables: triglycerides, HDL-c, arterial pressure and glucose in adolescents with abdominal obesity. The sample consisted of 393 adolescents of both genders between ages 10 and 14. Measurements were taken of abdominal circumference, arterial pressure, and laboratory exams of glucose, cholesterol HDL-c and triglycerides. The results showed that, in the nutritional condition, the male gender presented an obesity rate of 27.1, 4.3% overweight, and a rate of

  5. PET/CT Interpretation: Abdominal Anatomy

    Detail knowledge of abdominal anatomy is essential for accurate interpretation of oncologic PET/CT. The objective of this lecture is to provide the core knowledge and guidance about, peritoneal cavity, vessels, nodal, internal organ, especially liver segmental anatomy, and retroperitoneal spaces to nuclear medicine physicians in their interpretation of oncologic PET/CT. Peritoneal Cavity: The peritoneal spaces are easiest to recognize when there is ascites. The right subphrenic space communicates with anterior and posterior subhepatic (Morrison's) space. The left subphrenic space freely communicate with the left subhepatic space. The right and left subphrenic spaces are separated by falciform ligament and do not communicate directly. The lesser sac is the isolated peritoneal compartment between the stomach and pancreas. It communicates with the rest of the peritoneal cavity (greater sac) through the Foramen of Winslow. The right subphrenic and subhepatic spaces communicate freely with the pelvic peritoneal cavity thru the right paracolic gutter. The phrenicocolic ligament prevents free communication between the left subphrenic / subhepatic space and left paracolic gutter. Free fluid and peritoneal metastases commonly settles in pelvis as the most dependent portion of the peritoneal cavity. The small mesentery suspends the jejunum and ileum and extends obliquely from the left upper quadrant to right lower quadrant. Disease originating above the ligament is directed towards the right lower quadrant and below the ligament can spread to pelvis. The greater omentum hangs from the greater curvature of the stomach and descends in front of the abdominal viscera and serves as a fertile ground for peritoneal metastases. Vessels: The abdominal aorta descends anterior to the left side of the spine to its bifurcation at the level of the iliac crest. The normal aorta does not exceed 3 cm diameter and tapers progressively as it descends distally. The common iliac arteries

  6. Rabdomiólise por síndrome compartimental glútea após cirurgia bariátrica: relato de caso Rabdomiolisis por síndrome compartimental glúteo después de cirugía bariátrica: relato de caso Rhabdomyolysis secondary to gluteal compartment syndrome after bariatric surgery: case report

    Márcio Luiz Benevides

    2006-08-01

    a cirugía bariátrica tipo duodenal switch, bajo anestesia general asociada a la anestesia peridural. El procedimiento se dio sin incidencias. El tiempo anestésico quirúrgico fue de 3 horas y 30 minutos. El primer día del postoperatorio el paciente presentó dolor en la región lombosacral y en las nalgas, además de parestesia en los miembros inferiores en la distribución del nervio ciático. Durante el examen, las nalgas presentaban una discreta palidez, tensas, con edemas, dolían cuando eran tocadas y cuando se movían. Fue diagnosticado el síndrome compartimental glúteo que evolucionó con rabdomiolisis e insuficiencia renal aguda. Hubo una recuperación de la función renal y ninguna secuela motora o sensitiva se detectó. CONCLUSIONES: Los pacientes obesos mórbidos sometidos a la cirugía bariátrica pueden presentar síndrome compartimental glúteo. Cuando no se diagnostica y se trata precozmente, puede evolucionar con rabdomiolisis e insuficiencia renal aguda representando una seria amenaza para la vida.BACKGROUND AND OBJECTIVES: Bariatric surgery has become a common procedure and several complications have been reported. The objective of this report is to present a case of gluteal compartment syndrome that evolved to acute renal failure after bariatric surgery and to discuss the diagnosis, and the prophylactic and therapeutic measures. CASE REPORT: A 42 years old male patient, white, with a body mass index (BMI of 43, physical status ASA II, who underwent bariatric surgery of the duodenal switch type, under general anesthesia associated with epidural anesthesia. There were no complications during the procedure. The anesthetic-surgical procedure lasted 3 hours and 30 minutes. On postoperative day one the patient developed lumbosacral and gluteal pain, besides paresthesia in the lower limbs in the distribution of the sciatic nerve. On physical exam, the buttocks were slightly pale, tight, swollen, and painful to palpation and to movement. A diagnosis

  7. The effect of intra-abdominal hypertension incorporating severe acute pancreatitis in a porcine model.

    Lu Ke

    Full Text Available INTRODUCTION: Abdominal compartment syndrome (ACS and intra abdominal hypertension(IAH are common clinical findings in patients with severe acute pancreatitis(SAP. It is thought that an increased intra abdominal pressure(IAP is associated with poor prognosis in SAP patients. But the detailed effect of IAH/ACS on different organ system is not clear. The aim of this study was to assess the effect of SAP combined with IAH on hemodynamics, systemic oxygenation, and organ damage in a 12 h lasting porcine model. MEASUREMENTS AND METHODS: Following baseline registrations, a total of 30 animals were divided into 5 groups (6 animals in each group: SAP+IAP30 group, SAP+IAP20 group, SAP group, IAP30 group(sham-operated but without SAP and sham-operated group. We used a N(2 pneumoperitoneum to induce different levels of IAH and retrograde intra-ductal infusion of sodium taurocholate to induce SAP. The investigation period was 12 h. Hemodynamic parameters (CO, HR, MAP, CVP, urine output, oxygenation parameters(e.g., S(vO(2, PO(2, PaCO(2, peak inspiratory pressure, as well as serum parameters (e.g., ALT, amylase, lactate, creatinine were recorded. Histological examination of liver, intestine, pancreas, and lung was performed. MAIN RESULTS: Cardiac output significantly decreased in the SAP+IAH animals compared with other groups. Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in S(vO(2. The histopathological analyses also revealed higher grade injury of liver, intestine, pancreas and lung in the SAP+IAH groups. However, few differences were found between the two SAP+IAH groups with different levels of IAP. CONCLUSIONS: Our newly developed porcine SAP+IAH model demonstrated that there were remarkable effects on global hemodynamics, oxygenation and organ function in response to sustained IAH of 12 h combined with SAP. Moreover, our model should be helpful to study the mechanisms of IAH

  8. [Differential diagnosis of abdominal pain].

    Frei, Pascal

    2015-09-01

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain. PMID:26331201

  9. Dolor abdominal recurrente .

    Rodrigo De Vivero

    2009-11-01

    Full Text Available El dolor abdominal recurrente (DAR es un problema frecuente en la consulta médica y en la subespecialidad médica y quirúrgica. El DAR es frecuentemente funcional, es decir, sin una causa orgánica aparente. El diagnóstico diferencial debe incluir pérdida de peso, sangrado gastrointestinal, fiebre persistente, diarrea crónica y vómito importante. En este artículo se revisa el diagnóstico y tratamiento, pruebas diagnósticas y manejo farmacológico y ambiental.

  10. Hypnosis for functional abdominal pain.

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  11. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...

  12. Practical pediatric abdominal CT

    This course is designed to help the radiologist in a hospital setting successfully approach abdominal CT in the infant and child. Emphasis is placed on techniques necessary for a high-quality examination of the upper abdomen, as applied to common pediatric problems such as trauma, tumor, and infection. Material is presented on technical considerations, including patient sedation, preparation, and potential pitfalls and helpful hints for imaging. An emphasis is placed on dynamic scanning with table incrementation. The section on trauma focuses on an approach to imaging the abdomen in the injured child, typical injuries, patterns of injury in the upper abdomen, and why CT is the best imaging modality for blunt upper abdominal trauma. The discussion of tumor imaging reviews the appearance of typical childhood neoplasia including Wilms tumor, neuroblastoma, non-Hodgkin and Burkitt lymphoma, and disseminated solid tumors such as rhabdomyosarcoma. The authors emphasize what to look for and where, both on initial and on later (for recurrences) examinations. The discussion of infection addresses detection of abscesses and occult infections in children, as well as imaging of abscesses prior to intervention

  13. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  14. The Limb-Abdominal Wall Complex Defects, a form of Amniotic Band Sydrome: A Rare Case Report

    Das, Sudhanshu Ku.; Maharana, Sidharth Sankar; Subudhi, Monalisa; Rao, P. V. Subha

    2013-01-01

    The limb-body wall complex defects a form of amniotic band syndrome which consists of a polymal formation with a thoracic and /or an abdominal-schisis, eventration of the internal organ and anomalies of the extremities. We are presenting a case of a limb-body wall complex defect with the phenotype of a placenta-abdominal attachment, anomalies of the abdominal wall defect, absence of the right lower limb and genitourinary defects.

  15. The Limb-Abdominal Wall Complex Defects, a form of Amniotic Band Sydrome: A Rare Case Report.

    Das, Sudhanshu Ku; Maharana, Sidharth Sankar; Subudhi, Monalisa; Rao, P V Subha

    2013-03-01

    The limb-body wall complex defects a form of amniotic band syndrome which consists of a polymal formation with a thoracic and /or an abdominal-schisis, eventration of the internal organ and anomalies of the extremities. We are presenting a case of a limb-body wall complex defect with the phenotype of a placenta-abdominal attachment, anomalies of the abdominal wall defect, absence of the right lower limb and genitourinary defects. PMID:23634417

  16. Radiation nephritis causing nephrotic syndrome

    Jennette, J.C.; Ordonez, N.G.

    1983-12-01

    Clinical symptoms of acute radiation nephritis with nephrotic syndrome developed in a fifty-six-year-old woman after abdominal radiation therapy for an astrocytoma of the spinal cord. The diagnosis of radiation nephritis was confirmed by renal biopsy. To our knowledge, this is the first documented case of radiation nephritis associated with nephrotic syndrome.

  17. Abdominal Burkitt lymphoma

    Purpose: As scarce information is available, in this research we have tried to describe the imaging findings of the Burkitt's lymphoma. Retrospective analysis of the clinical and imaging presentation of a 4 years old boy, is given. Biopsy confirmed the BL. Different imaging techniques were combined. The X-rays were negative. The US revealed a moderate hepatomegaly with multiple hypoechoic nodules and free fluid in the abdominal cavity. The CT showed the hepatomegaly as well as solid nodules in great number and different sizes(due to the densitometric behaviour and to post contrast enhancement), a scarce amount of ascites and a density increase of the mesentery fat. The MRI characterized and revealed in detail the US and the CT findings. The Burkitt's lymphoma is a rare entity; several methods are needed to approach the diagnosis. It represents a great clinical and imaging challenge. (author)

  18. Post-dialysis urea concentration: comparison between one- compartment model and two-compartment model

    The reduction of the urea concentration in blood can be numerically projected by using one-compartment model and two-compartment model with no variation in body fluid. This study aims to compare the simulated values of post-dialysis urea concentration for both models with the clinical data obtained from the hospital. The clinical assessment of adequacy of a treatment is based on the value of Kt/V. Further, direct calculation using clinical data and one-compartment model are presented in the form of ratio. It is found that the ratios of postdialysis urea concentration simulated using two-compartment model are higher compared to the ratios of post-dialysis urea concentration using one-compartment model. In addition, most values of post-dialysis urea concentration simulated using two-compartment model are much closer to the clinical data compared to values simulated using one-compartment model. Kt/V values calculated directly using clinical data are found to be higher than Kt/V values derived from one-compartment model

  19. Post-dialysis urea concentration: comparison between one- compartment model and two-compartment model

    Tamrin, N. S. Ahmad; Ibrahim, N.

    2014-11-01

    The reduction of the urea concentration in blood can be numerically projected by using one-compartment model and two-compartment model with no variation in body fluid. This study aims to compare the simulated values of post-dialysis urea concentration for both models with the clinical data obtained from the hospital. The clinical assessment of adequacy of a treatment is based on the value of Kt/V. Further, direct calculation using clinical data and one-compartment model are presented in the form of ratio. It is found that the ratios of postdialysis urea concentration simulated using two-compartment model are higher compared to the ratios of post-dialysis urea concentration using one-compartment model. In addition, most values of post-dialysis urea concentration simulated using two-compartment model are much closer to the clinical data compared to values simulated using one-compartment model. Kt/V values calculated directly using clinical data are found to be higher than Kt/V values derived from one-compartment model.

  20. Tobacco and metabolic syndrome

    Yatan Pal Singh Balhara

    2012-01-01

    Full Text Available Tobacco is a leading contributor to morbidity and mortality globally. Metabolic syndrome is a constellation of abdominal obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistance (with and without glucose intolerance, pro-inflammatory state, and pro-thrombotic state. Tobacco use is associated with various core components of metabolic syndrome. It has been found to play a causal role in various pathways leading on to development this condition, the current article discusses various facets of this association.

  1. Irritable bowel syndrome.

    Beck, E.; Hurwitz, B

    1992-01-01

    1. Irritable bowel syndrome is a functional disorder of the lower intestinal tract affecting approximately 10% of the population and causing a wide range of symptoms. 2. Most cases of irritable bowel syndrome can be diagnosed in general practice on the basis of the presenting history and clinical examination but some patients may need to be referred to a gastro-enterologist for further assessment including sigmoidoscopy and barium enema. 3. The clinical picture may include symptoms of abdomin...

  2. Clinical Study on the Effect of Abdominal Acupuncture Combined with Metformin in Obese Patients with Polycystic Ovary Syndrome%腹针联合二甲双胍治疗肥胖型多囊卵巢综合征患者的临床研究

    李凝; 巩静; 华川

    2016-01-01

    目的:观察针刺结合二甲双胍治疗肥胖型多囊卵巢综合征(polycystic ovary syndrome ,P‐COS)的临床疗效。方法将18~36岁肥胖型 PCOS患者42例随机分为腹针组、二甲双胍组及腹针联合二甲双胍组,每组各14例。3组连续治疗6个月后,在月经周期第3~5天或闭经者经B超检查未见优势卵泡时,检查血性激素(LH、FSH、LH/FSH)水平、BMI指数及腰腹围指标。结果治疗后,3组性激素水平、BMI指数及腰腹围指标均较治疗前明显改善(P<0.05);组间比较,腹针组和二甲双胍组性激素水平、BMI指数及腰腹围指标差异均无统计学意义(P>0.05),但腹针联合二甲双胍组上述指标的改善效果明显优于腹针组和二甲双胍组(P<0.05)。结论针刺配合二甲双胍治疗肥胖型 PCOS 优于单独采用针刺治疗或单用二甲双胍治疗。%Objective To observe the clinical effect of abdominal acupuncture combined with metformin in treating obese polycystic ovary syndrome(PCOS).Methods Obese PCOS patients with age between 18~36 were divided into abdominal acupuncture group ,metformin group and integrated (abdominal acupuncture combined with metformin)group randomly ,with 14 cases in each group. All patients were treated for half a year.Serum level of sex hormones ,body mass index(BMI)and abdomen circumference(AC)were observed and compared among three groups.Results After treatment ,the weight ,AC ,BMI and sex hormones of three groups were all improved obvi‐ously(P<0.05). The weight ,AC ,BMI and sex hormones of integrated group improved more obviously than ab‐dominal acupuncture group and metformin group (P< 0.05) ,and there was no significant difference between ab‐dominal acupuncture group and metformin group.Conclusion The treatment of abdominal acupuncture combined with metformin is superior to the treatment of abdominal acupuncture or metformin only.

  3. The Severity of Nocturnal Hypoxia but Not Abdominal Adiposity Is Associated with Insulin Resistance in Non-Obese Men with Sleep Apnea

    Anne-Laure Borel; Denis Monneret; Renaud Tamisier; Jean-Philippe Baguet; Patrice Faure; Patrick Levy; Serge Halimi; Jean-Louis Pépin

    2013-01-01

    BACKGROUND: Beyond obesity, sleep apnea syndrome is frequently associated with excess abdominal adiposity that could contribute to the deteriorated cardiometabolic risk profile of apneic patients. METHODS: The present study addressed the respective contribution of the severity of sleep apnea syndrome and excess abdominal adiposity to the cardiometabolic risk profile of 38 non obese men with polysomnography-diagnosed sleep apnea syndrome (apnea-hypopnea index >15 events/hour). These otherwise ...

  4. Unclear Abdominal Discomfort: Pivotal Role of Carbohydrate Malabsorption

    Goebel-Stengel, Miriam; Stengel, Andreas; Schmidtmann, Marco; van der Voort, Ivo; Kobelt, Peter; Mönnikes, Hubert

    2014-01-01

    Background/Aims Carbohydrate malabsorption is frequent in patients with functional gastrointestinal disorders and in healthy volunteers and can cause gastrointestinal symptoms mimicking irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of symptomatic lactose and fructose malabsorption in a large population of patients with IBS-like symptoms based on Rome II criteria. Methods Patients with unclear abdominal discomfort (n = 2,390) underwent lactose (50 g) a...

  5. Abdominal aortic aneurysm demonstrated on renal scintigraphy.

    Phisitkul, Sorot; Brian, Susan; Rakvit, Ariwan; Jenkins, Leigh A; Bohannon, W Todd; Harris, Jennifer; Tsikouris, James; Silva, Michael B; Meyerrose, Gary E

    2003-08-01

    A 74-year-old hypertensive woman presented with abdominal discomfort and a pulsatile abdominal mass. Anterior abdominal angiography during cardiac blood pool, and renal scintigraphic imaging demonstrated a large abdominal aortic aneurysm. 1, 2 Before endovascular repair with an aortoiliac endograft, the abdominal aneurysm measured 7.5 x 7.0 cm on abdominal computed tomography. This study demonstrates that a suspected abdominal aortic aneurysm can be confirmed using the addition of anterior abdominal imaging with normal posterior imaging at the time of renal scintigraphy. PMID:12897671

  6. Space Shuttle crew compartment debris-contamination

    Goodman, Jerry R.; Villarreal, Leopoldo J.

    1992-01-01

    Remedial actions undertaken to reduce debris during manned flights and ground turnaround operations at Kennedy Space Center and Palmdale are addressed. They include redesign of selected ground support equipment and Orbiter hardware to reduce particularization/debris generation; development of new detachable filters for air-cooled avionics boxes; application of tape-on screens to filter debris; and implementation of new Orbiter maintenance and turnaround procedures to clean filters and the crew compartment. Most of these steps were implemented before the return-to-flight of STS-26 in September 1988 which resulted in improved crew compartment habitability and less potential for equipment malfunction.

  7. Practical human abdominal fat imaging utilizing electrical impedance tomography

    The fundamental cause of metabolic syndrome is thought to be abdominal obesity. Accurate diagnosis of abdominal obesity can be done by an x-ray computed tomography (CT) scan. But CT is expensive, bulky and entails the risks involved with radiation. To overcome such disadvantages, we attempted to develop a measuring device that could apply electrical impedance tomography to abdominal fat imaging. The device has 32 electrodes that can be attached to a subject's abdomen by a pneumatic mechanism. That way, electrode position data can be acquired simultaneously. An applied alternating current of 1.0 mArms was used at a frequency of 500 kHz. Sensed voltage data were carefully filtered to remove noise and processed to satisfy the reciprocal theorem. The image reconstruction software was developed concurrently, applying standard finite element methods and the Marquardt method to solve the mathematical inverse problem. The results of preliminary experiments showed that abdominal subcutaneous fat and the muscle surrounding the viscera could be imaged in humans. While our imaging of visceral fat was not of sufficient quality, it was suggested that we will be able to develop a safe and practical abdominal fat scanner through future improvements

  8. Catastrophic primary antiphospholipid syndrome

    Catastrophic antiphospholipid syndrome (CAPLS) was diagnosed in a 64-year-old male who was admitted to our hospital with dyspnea. The clinical and radiological examinations showed pulmonary thromboembolism, and so thromboembolectomy was performed. Abdominal distension rapidly developed several days later, and the abdominal computed tomography (CT) abdominal scan revealed thrombus within the superior mesenteric artery with small bowel and gall bladder distension. Cholecystectomy and jejunoileostomy were performed, and gall bladder necrosis and small bowel infarction were confirmed. The anticardiolipin antibody was positive. Anticoagulant agents and steroids were administered, but the patient expired 4 weeks after surgery due to acute respiratory distress syndrome (ARDS). We report here on a case of catastrophic APLS with manifestations of pulmonary thromboembolism, rapidly progressing GB necrosis and bowel infarction

  9. Catastrophic primary antiphospholipid syndrome

    Kim, Dong Hun; Byun, Joo Nam [Chosun University Hospital, Gwangju (Korea, Republic of); Ryu, Sang Wan [Miraero21 Medical Center, Gwangju (Korea, Republic of)

    2006-09-15

    Catastrophic antiphospholipid syndrome (CAPLS) was diagnosed in a 64-year-old male who was admitted to our hospital with dyspnea. The clinical and radiological examinations showed pulmonary thromboembolism, and so thromboembolectomy was performed. Abdominal distension rapidly developed several days later, and the abdominal computed tomography (CT) abdominal scan revealed thrombus within the superior mesenteric artery with small bowel and gall bladder distension. Cholecystectomy and jejunoileostomy were performed, and gall bladder necrosis and small bowel infarction were confirmed. The anticardiolipin antibody was positive. Anticoagulant agents and steroids were administered, but the patient expired 4 weeks after surgery due to acute respiratory distress syndrome (ARDS). We report here on a case of catastrophic APLS with manifestations of pulmonary thromboembolism, rapidly progressing GB necrosis and bowel infarction.

  10. Budd–Chiari Syndrome: an unnoticed diagnosis

    Falcão, Camila Kruschewsky; Fagundes, Gustavo C. Freitas; Lamos, Gustavo Checolli; Felipe-Silva, Aloisio; Lovisolo, Silvana Maria; Martines, João Augusto; de Campos, Fernando Peixoto Ferraz

    2015-01-01

    Budd–Chiari syndrome (BCS) encompasses a group of disorders caused by the obstruction to the hepatic venous outflow at the level of the small or large hepatic veins, the inferior vena cava, or any combination thereof. Clinical manifestation of the subacute form is characterized by supramesocolic abdominal discomfort, abdominal distension, fever, and lower limbs edema. Imaging work-up with hepatic Doppler ultrasound and abdominal computed tomography (CT) enables the diagnosis in the majority o...

  11. Penetrating abdominal trauma.

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  12. Economics of abdominal wall reconstruction.

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. PMID:24035086

  13. Abdominal manifestations of cystic fibrosis in children

    Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities. (orig.)

  14. Abdominal manifestations of cystic fibrosis in children

    Chaudry, Gulraiz; Navarro, Oscar M.; Levine, Daniel S.; Oudjhane, Kamaldine [University of Toronto, Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada)

    2006-03-15

    Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities. (orig.)

  15. Unexplained, self-reported food hypersensitivity. Explorative studies on mechanisms of abdominal symptom generation

    Valeur, Jørgen

    2010-01-01

    Background: Self-reported food hypersensitivity remains unexplained in most cases. Abdominal symptoms, typically consistent with the irritable bowel syndrome (IBS), are common in patients with such unexplained, self-reported food hypersensitivity. The etiology is obscure. Aim: The overall objective of the present study was to investigate possible mechanisms of postprandial abdominal symptom generation. A main purpose was to explore whether and how ingestion of low-digestible...

  16. Genetics Home Reference: Miller-Dieker syndrome

    ... allows the abdominal organs to protrude through the navel. People with Miller-Dieker syndrome may also have ... Disorders and Stroke: Seizures and Epilepsy: Hope Through Research Educational Resources (4 links) Cleveland Clinic: Lissencephaly Disease ...

  17. Gastrointestinal (GI) permeability correlates with trait anxiety and urinary norepinephrine/creatinine (CR)ratio in children with functional abdominal pain (FAP)and irritable bowel syndrome (IBS) but not in controls

    FAP and IBS affect 10–15% of school age children and bear many similarities to irritable bowel syndrome (IBS) in adults (e.g., functional pain, visceral hyperalgesia). Animal models of IBS have suggested a relationship between neonatal stress/anxiety and increased GI permeability later in life. We h...

  18. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... located within a child's abdomen. A Doppler ultrasound study may be part of a child's abdominal ultrasound ... pain from the procedure. If a Doppler ultrasound study is performed, your child may actually hear pulse- ...

  19. JAMA Patient Page: Abdominal Hernia

    ... an operation. Umbilical hernia Abdominal wall Intestinal loop Peritoneum Skin Peritoneum Umbilical annulus SYMPTOMS The first symptom of a ... vomiting, or constipation. Inguinal hernia Indirect inguinal hernia Peritoneum Deep inguinal ring Inguinal canal Superficial inguinal ring ...

  20. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... technique that allows the physician to see and evaluate blood flow through arteries and veins in the ... the procedure? Abdominal ultrasound imaging is performed to evaluate the: appendix stomach/ pylorus liver gallbladder spleen pancreas ...

  1. Component separation in abdominal trauma

    Rawstorne, Edward; Smart, Christopher J.; Fallis, Simon A.; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and t...

  2. Abdominal muscle training in sport.

    Norris, C M

    1993-01-01

    This paper evaluates several abdominal exercises, and highlights factors which are important for their safe prescription and effective use. The function of the abdominal muscles and hip flexors is considered, and the importance of the infra-umbilical portion of the rectus abdominis is emphasized. The effects of flexion on the lumbar spine are outlined. The trunk curl, sit-up, and straight leg raise are analysed, together with modifications of these exercises. The effect of foot fixation and h...

  3. Computer tomography following blunt abdominal trauma

    The computer tomographic appearances of lesions of parenchymatous organs following blunt abdominal trauma are described in 13 patients (five liver, four renal, two splenic and two pancreatic injuries). The value of abdominal computer tomography is discussed in relation to the interval between injury and time of abdominal examination and compared with the diagnostic value of abdominal angiography. (orig.)

  4. Imaging of gastrointestinal and abdominal tuberculosis

    Vanhoenacker, FM; De Backer, AI; Op de Beeck, B; Maes, M; Van Altena, R; Van Beckevoort, D; Kersemans, P; De Schepper, AM

    2004-01-01

    This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic cha

  5. Diet in irritable bowel syndrome

    El-Salhy, Magdy; Gundersen, Doris Irene

    2015-01-01

    Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that is characterized by intermittent abdominal pain/discomfort, altered bowel habits and abdominal bloating/distension. This review aimed at presenting the recent developments concerning the role of diet in the pathophysiology and management of IBS. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, and there is no evidence that gluten causes the debated new diagnosis of non-coel...

  6. Anesthetic considerations in Demons-Meigs’ syndrome: a case report

    Fjouji, Salaheddine; Bensghir, Mustapha; Haimeur, Charki; Azendour, Hicham

    2014-01-01

    Introduction Demons-Meigs’ syndrome is characterized by the presence of a benign ovarian tumor associated with ascites and a right-sided hydrothorax. Its pathophysiology remains unclear. Anesthesia of this syndrome is a real challenge. Respiratory, hemodynamic, metabolic problems and abdominal hypertension are the main anesthetic risks. Case presentation A 52-year-old African woman with Demons-Meigs’ syndrome was admitted for elective surgery under general anesthesia. An abdominal computed to...

  7. Correlation of abdominal adiposity with components of metabolic syndrome, anthropometric parameters and Insulin resistance, in obese and non obese, diabetics and non diabetics: A cross sectional observational study. (Mysore Visceral Adiposity in Diabetes Study)

    M Premanath; H Basavanagowdappa; Mahesh, M.; Suresh, M.

    2014-01-01

    Objectives : To measure Visceral Fat (VF) and Subcutaneous Fat (SCF) by ultrasound, in obese and non-obese diabetics and obese and non-obese non diabetics, in a South Indian (Asian Indian) Population and correlate them with Body Mass Index (BMI), Waist Circumference (WC), components of metabolic syndrome and Insulin Resistance (IR) Research Design and Methods: This was a prospective observational study, 80 diabetics (40 obese and 40 non obese) and 80 non diabetics (40 obese and 40 non obese) ...

  8. Ergonomic Evaluation on Taxi Drivers Compartment

    Jimmy; SF; Chan; YW; Chui; Reggie; Kwan; K; K; Chau

    2002-01-01

    Driving involves long hours of physical work within c onfined compartment. Taxi drivers usually work with prolonged working hours, add itional stress may likely be induced on particular body limbs. Occupational heal th may occur and working efficiency may potentially be affected resulting fr om fatigues, pains or diseases. These problems, however, could be remedied if mo re attention is paid on seating design, the workplace and driving postures adopt ed. Ergonomics design can provide better understanding...

  9. Detection of abdominal bleeding in blunt abdominal trauma

    Arterial hemorrhage is the most serious immediate complication of blunt abdominal trauma. This paper discusses the detection and localization of active hemorrhage in nonpenetrating injury, as a modification of the technique using technetium-99m sulfur colloid to localize the site of active bleeding in the gastrointestinal tract. Any imaging protocol for suspected hepatosplenic injury can be easily modified to search for active intra-abdominal hemorrhage. The timely detection of unsuspected bleeding improves patient management by allowing the surgeon to reorder his or her treatment priorities. The early detection of clinically unsuspected intra-abdominal, retroperitoneal, or pelvic hemorrhage will identify those patients who may need more definitive diagnostic procedures, interventional angiography for control of bleeding, or surgical intervention. The 500,000-count view of the abdomen and pelvis can be easily incorporated into any existing trauma protocol using technetium-99m sulfur colloid, is of proven value, and adds little additional time to the study

  10. Monoterpene biosynthesis potential of plant subcellular compartments.

    Dong, Lemeng; Jongedijk, Esmer; Bouwmeester, Harro; Van Der Krol, Alexander

    2016-01-01

    Subcellular monoterpene biosynthesis capacity based on local geranyl diphosphate (GDP) availability or locally boosted GDP production was determined for plastids, cytosol and mitochondria. A geraniol synthase (GES) was targeted to plastids, cytosol, or mitochondria. Transient expression in Nicotiana benthamiana indicated local GDP availability for each compartment but resulted in different product levels. A GDP synthase from Picea abies (PaGDPS1) was shown to boost GDP production. PaGDPS1 was also targeted to plastids, cytosol or mitochondria and PaGDPS1 and GES were coexpressed in all possible combinations. Geraniol and geraniol-derived products were analyzed by GC-MS and LC-MS, respectively. GES product levels were highest for plastid-targeted GES, followed by mitochondrial- and then cytosolic-targeted GES. For each compartment local boosting of GDP biosynthesis increased GES product levels. GDP exchange between compartments is not equal: while no GDP is exchanged from the cytosol to the plastids, 100% of GDP in mitochondria can be exchanged to plastids, while only 7% of GDP from plastids is available for mitochondria. This suggests a direct exchange mechanism for GDP between plastids and mitochondria. Cytosolic PaGDPS1 competes with plastidial GES activity, suggesting an effective drain of isopentenyl diphosphate from the plastids to the cytosol. PMID:26356766

  11. [Arthritis of the Medial Knee Joint Compartment].

    Matziolis, G; Röhner, E

    2015-10-01

    23 % of all persons older than 65 years suffer from osteoarthritis of the medial compartment of the knee joint, a very common situation in orthopaedic practice 1. As a result of the demographic trend the number of patients is expected to increase in the future. Based on specific joint biomechanics and kinematics the medial knee joint compartment is more frequently affected than the lateral. Only an understanding of the functional anatomy and underlying pathology allows a critical evaluation of different available conservative and operative treatment options. This article gives an overview of diagnostic and therapeutic strategies of osteoarthritis of the medial knee joint. Frequently performed surgeries, e.g. high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) will be presented in a comparative manner. The actual scientific evidence will be given with the goal of an evidence based therapy that is adopted to stage and pathology of osteoarthritis of the medial compartment of the knee joint. PMID:26451864

  12. Computed tomography of the cervical compartments on the computer tomogram

    Zaunbauer, W.; Haertel, M.

    1984-02-01

    The computed tomographic anatomy of the cervical compartments, with emphasis on the fascial planes of the neck, is described. Typical disease processes within these fascial confined compartments have been documented.

  13. Forest Management Prescription : Compartment 9 : Mingo National Wildlife Refuge

    US Fish and Wildlife Service, Department of the Interior — This is the Forest Management Prescription for Compartment 9 of Mingo NWR. It provides a description of the compartment, management objectives, proposed management...

  14. 改良Whiteside法与负压封闭引流技术在诊治骨筋膜间室综合征中的应用%Modified Whiteside method plus vacuum sealing drainage in the treatment of osteofascial compartment syndrome

    曾展鹏; 黄枫; 苏博源

    2012-01-01

    Objective To investigate an early diagnostic method and a rapid efficient treatment method to teat osteofascial compartment syndrome (OCS). Methods From January 2007 through December 2008,16 male patients with OCS were treated in our department.They were aged from 15 to 55 years (average,32 years).Twelve patients had OCS at the leg and 4 at the foot.All patients had no vascular or nerval injury.The modified Whiteside method was used to measure the pressue of the osteofascial compartment.All patients were treated with open decompression and vacuum sealing drainage (VSD).After swelling subsided,the wounds were directly sutured,decompresively sutured or treated with skin grafting. Merchant scoring was used to evaluate the postoperative efficacy in terms of limb-affected function,pain,gait,joint function,joint stability and range of motion. Results All patients were followed up for 12 to 14 months (average,13 months).All incisions closed up.Fourteen patients obtained excellent recovery of the function and sensation of the distal limb-affected; one patient had hypoesthesia and numbness at the the distal limb-affected; one patient had contracture,numbness and functional disturbance.By the Merchant scoring system,9 cases were excellent,5 good and 2 fair,giving a good to excellent rate of 87.5%. Conclusions The modified Whiteside method used to meausre the interstitial pressure is a reliable early diagnostic method for OCS.Decompression plus VSD may lead to rapid and efficient treatment of OCS and a reduced disability rate of the limb-affected.%目的 探讨骨筋膜间室综合征(OCS)的早期诊断方法及迅速、有效的临床治疗方法. 方法 2007年1月至2008年12月共收治16例OCS患者,均为男性;年龄15~55岁,平均32岁.OCS部位:小腿部12例,足部4例.全部患者均无血管神经损伤.采用改良Whiteside法测量筋膜间室内压力,切开减压使用负压封闭引流(VSD)技术治疗.肿胀基本消退后,创面予以直接缝合或

  15. Videolaparoscopia no trauma abdominal Videolaparoscopy in the abdominal trauma

    Átila Varela Velho

    2000-04-01

    Full Text Available A videolaparoscopia (VL vem contribuindo de forma crescente, para diagnóstico e terapêutica de várias afecções cirúrgicas abdominais, introduzindo profundas mudanças na cirurgia contemporânea. Esse avanço incorporou-se também às urgências traumáticas, fazendo parte da avaliação diagnóstica e, às vezes, da terapêutica do trauma abdominal. Os autores apresentam uma revisão concisa da literatura sobre a VL no trauma, atualizando o tema e discutindo os aspectos mais relevantes das indicações, limitações e complicações do método.Videolaparoscopy has been contributing for the diagnostic and therapeutic approach in the abdominal surgical diseases in the last years. Representing real modification in the conventional elective and traumatic abdominal surgery. Its has been recognized as a safe procedure for the diagnosis and treatment of abdominal trauma. Diagnostic predictive values, sensibility and specificity are greater than when obtained by the other diagnostic methods such as peritoneal lavage, ultrasonography and computed tomography. Despite their limitations, when indicated for selected patients seems to reduce non terapeutic laparotomies, postoperative morbidity, hospital stay and costs. The authors present a review of the literature regarding videolaparoscopy in the abdominal trauma, its limitations and complications. Based an a complex protocol for the indications of videolaparoscopy for abdominal trauma, the authors sugested their exclusive use by level trauma centers.

  16. A clinical dilemma: abdominal tuberculosis

    Oya Uygur-Bayramicli; G(u)l Dabak; Resat Dabak

    2003-01-01

    AIM: To evaluate the clinical, radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis.METHODS: Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital,Istanbul, Turkey were evaluated prospectively. Complete physical examination, medical and family history, blood count erythrocyte sedimentation rate, routine biochemical tests,Mantoux skin test, chest X-ray and abdominal ultrasonography (USG) were performed in all cases, whereas microbiological examination of ascites, upper gastrointestinal endoscopy, colonoscopy or barium enema, abdominal tomography, mediastinoscopy, laparoscopy or laparotomy were done when needed.RESULTS: The median age of patients (14 females, 17males) was 34.2 years (range 15-65 years). The most frequent symptoms were abdominal pain and weight loss.Eleven patients had active pulmonary TB. The most common abdominal USG findings were ascites and hepatomegaly. Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2 %). Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients. Colonoscopy performed in 20 patients showed ulcers in 9 (45 %), nodules in 2 (10 %)and, stricture, polypoid lesions, granulomatous findings in terminal ileum and rectal fistula each in one patient (5 %).Laparoscopy on 4 patients showed dilated bowel loops,thickening in the mesentery, multiple ulcers and tubercles on the peritoneum. Patients with abdominal TB were divided into three groups according to the type of involvement.Fifteen patients (48 %) had intestinal TB, L1 patients (35.2 %) had tuberculous peritonitis and 5 (16.8 %)tuberculous lymphadenitis. The diagnosis of abdominal TB was confirmed microbiologically in 5 (16 %) and histopathologically in 19 patients (60.8 %). The

  17. Abdominal tuberculosis and amoebic abscess. Abdominal tuberkulose og amoebeabscess

    Myklebust, G.; Bardstad, J.; Brabrand, K. (Aust-Agder Central Hospital, Arendal (Norway))

    1993-03-01

    A 26-years-old Indian male was admitted to hospital with loss of weight and vague abdominal pain of several weeks duration. Ultrasonography and computed tomography showed several expansive lesions near the pancreatic head, probably representing enlarged lymph nodes. A few milliliters of yellowish pus were aspirated by ultrasound guided aspiration. Microscopic examination of the pus showed trophozoits, and mycobacterium tuberculosis subsequently grew from the pus culture. Abdominal tuberculosis is a rare condition, particularly in the pancreas and the peripancreatic region. The report stresses the importance of considering the possible coexistance of more than one infectious disease in patients from endemic areas. 21 refs., 2 figs.

  18. Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis

    Juvenal da Rocha Torres Neto; Adonai Pinheiro Barreto; Ana Carolina Lisboa Prudente; Allisson Mário dos Santos; Rodrigo Rocha Santiago

    2007-01-01

    Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, ...

  19. Contemporary imaging in abdominal emergencies

    Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)

  20. CT evaluation of abdominal trauma

    Objective: An evaluation of CT diagnosis of abdominal trauma. Methods: CT appearance of abdominal trauma was analyzed retrospectively in 95 cases. thirty-three patients were cured by operation, and the other 59 patients received conservative treatment. Fifty-one patients out of 59 were seen healed or improved by a follow up CT scan after the conservative treatment. Results: The study included: 31 cases of splenic contusion, accompanying with hemoperitoneum in 25 cases; 3 cases of hepatic laceration; 33 cases of liver and spleen compound trauma accompanying with hemoperitoneum; 18 cases of renal contusion, with subcapsular hemorrhage in 12 cases; 4 cases of midriff colic; 3 cases of mesentery breach; 3 cases of digestive tract perforation. Conclusion: CT is sensitive and precise in evaluating abdominal trauma, providing important information for treatment. (author)

  1. Contemporary imaging in abdominal emergencies

    Sivit, Carlos J. [Rainbow Babies and Children' s Hospital, Case Western Reserve School of Medicine, Department of Radiology, Cleveland, OH (United States)

    2008-11-15

    Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)

  2. Abdominal wall hernia and pregnancy

    Jensen, K K; Henriksen, N A; Jorgensen, L N

    2015-01-01

    Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery of......PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub...... incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...

  3. Abdominal radiation causes bacterial translocation

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa

  4. Radiological evaluation of abdominal trauma

    Simple abdomen film has played an important role in decision of emergency operations in patients with the abdominal trauma. Nowadays, it still acts as a primary and inevitable processes in emergency condition. At the Department of Radiology, Hanil Hospital, 70 patients, who were laparotomied due to penetrating or nonpernetraing abdominal trauma, were observed and analyzed with simple abdomen film after comparison with the operative findings. The results are as follows: 1. Most frequent age distribution was 10 to 39 years and marked 70%. Male was in 90% incidence. 2. Penetrating injury largely involved the small bowel and abdominal wall. Non-penetrating injury usually involved the spleen, small bowel, liver, kidney, pancreas, duodenum. 3. Single organ injury occurred in higher incidence at the small bowel and abdominal wall. Multiple organ injury occurred in higher incidence at the spleen, liver, kidney and pancreas. 4. Organ distribution was 26% in spleen, 22% in small bowel, 14% in liver, 11% in abdominal wall. 7% in pancreas, 7% in kidney. 5% in duodenum, 4% in GB and CBD, 2% in diaphragm, 2% in colon, and 1% in stomach. 5. The specific roentgen findings and their frequency which useful in differential diagnosis at abdominal trauma, were as follows: a) flank fluid; Detectable possibility was 71% in liver laceration, 69% in spleen laceration and 57% in pancreas laceration. b) ipsilateral psoas shadow obliteration; Detectable possibility was 57% in liver laceration, 57% in kidney laceration and 46% in spleen laceration. c) free air; Detactable possibility was 60% in duodenal perforation, and 36% in peroration of upper part of small bowel. d) Reflex ileus; Detectable possibility was 64% in small bowel, 50% in liver laceration and 35% in spleen laceration. e) rib fracture; Detactable possibility was 36% in liver laceration and 23% in spleen laceration. f) pleural effusion; Detectable possibility was 29% in liver laceration and 27% in spleen laceration

  5. Mindfulness Intervention for Stress Eating to Reduce Cortisol and Abdominal Fat among Overweight and Obese Women: An Exploratory Randomized Controlled Study

    Elissa Epel; Lori Karan; Margaret Kemeny; Lustig, Robert H.; Margaret Kuwata; Jennifer Daubenmier; Nicole Maninger; Hecht, Frederick M.; Kinnari Jhaveri; Jean Kristeller

    2011-01-01

    Psychological distress and elevated cortisol secretion promote abdominal fat, a feature of the Metabolic Syndrome. Effects of stress reduction interventions on abdominal fat are unknown. Forty-seven overweight/obese women (mean BMI = 31.2) were randomly assigned to a 4-month intervention or waitlist group to explore effects of a mindfulness program for stress eating. We assessed mindfulness, psychological distress, eating behavior, weight, cortisol awakening response (CAR), and abdominal fat ...

  6. Secondary abdominal appendicular ectopic pregnancy.

    Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac

    2007-01-01

    Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy. PMID:17630175

  7. CT appearances of abdominal tuberculosis

    Lee, W.-K., E-mail: leewk33@hotmail.com [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)

    2012-06-15

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  8. CT appearances of abdominal tuberculosis

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  9. Recurrent abdominal pain in children.

    Buch, Niyaz A; Ahmad, Sheikh Mushtaq; Ahmed, S Zubair; Ali, Syed Wazid; Charoo, B A; Hassan, Masood Ul

    2002-09-01

    Eighty five children with recurrent abdominal pain(RAP) were studied. Organic cause was noticed in 70 cases and non-organic in 15 cases. Giardiasis was the commonest organic cause in 57 (67.0 percent), either alone or with other parasitic infestations. Other organic causes include gallstones (4.7 percent), urinary infections (4.7 percent), esophagitis/gastritis (3.5 percent) and abdominal tuberculosis (2.3 percent). Single parent, school phobia, sibling rivalry, RAP in other family members and nocturnal enuresis are significant factors associated with nonorganic causes PMID:12368527

  10. Abdominal aorta coarctation: The first three case reports in our literature

    Gajin Predrag; Tanasković Slobodan; Nenezić Dragoslav; Ilijevski Nenad; Radak Đorđe

    2010-01-01

    Introduction. Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5-2.0%) of aortic coarctation is located in the distal thoracic aorta or abdominal aorta or both and is often called 'middle aortic syndrome' or 'midaortic dysplastic syndrome'. This represents serious pathological condition and indicates multidisciplinary therapy approach. Outline of Cases. From 1996 to 2007, at the Vascular Surgery ...

  11. An unusual cause of dyspnoea complicating right upper abdominal swelling

    Sanjay Kumar Mandal; Partha Pratim Chakraborty; Rana Bhattacharjee; Subhasis Roy Chowdhury; Shounak Majumdar

    2006-01-01

    A middle aged, non-addict male presented with right upper abdominal pain and swelling with respiratory distress. Examination revealed central cyanosis, bipedal pitting edema with prominentepigastric and back veins.Liver was enlarged, tender, spanned 20 cm without any splenomegaly or ascites. Other systems were clinically normal. Laboratory investigations showed polymorphonuclear leucocytosis with slightly deranged liver function. Abdominal ultrasonography showed an abscess in the right lobe of the liver with compressed inferior vena cava (IVC), middle and left hepatic veins.Arterial blood gas (ABG) documented hypoxia with orthodeoxia and air-contrast echocardiography was suggestive of an intrapulmonary shunt. A diagnosis of hepato-pulmonary syndrome (HPS) was made with near normal liver function secondary to amebic liver abscess.It reversed completely following successful treatment of the liver abscess.

  12. Plain abdominal film and abdominal ultrasound in intestine occlusion

    Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificy of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecistis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echigenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus

  13. Multi-compartment linear noise approximation

    The ability to quantify the stochastic fluctuations present in biochemical and other systems is becoming increasing important. Analytical descriptions of these fluctuations are attractive, as stochastic simulations are computationally expensive. Building on previous work, a linear noise approximation is developed for biochemical models with many compartments, for example cells. The procedure is then implemented in the software package COPASI. This technique is illustrated with two simple examples and is then applied to a more realistic biochemical model. Expressions for the noise, given in the form of covariance matrices, are presented. (paper)

  14. Splines and compartment models an introduction

    Biebler, Karl-Ernst

    2013-01-01

    This book presents methods of mathematical modeling from two points of view. Splines provide a general approach while compartment models serve as examples for context related to modeling. The preconditions and characteristics of the developed mathematical models as well as the conditions surrounding data collection and model fit are taken into account. The substantial statements of this book are mathematically proven. The results are ready for application with examples and related program codes given. In this book, splines are algebraically developed such that the reader or user can easily u

  15. Frequency of abdominal obesity and its association with diabetes mellitus among people of peshawar

    Background: Increased body weight is a major risk factor for the metabolic syndrome which is a cluster of coronary heart disease risk factors, like: hypertension, diabetes mellitus and dyslipidaemia. This study was conducted to determine the frequency of abdominal obesity and diabetes mellitus in the population of Peshawar and association between them. Method: This was a cross sectional study, performed by the Cardiology Department, Lady Reading Hospital Peshawar, in the population of Peshawar. All participants were interviewed in detail regarding known risk factors for coronary artery disease. Waist circumference (=102 cm in male and =88 cm in females) was used as the surrogate marker for abdominal obesity in already diagnosed patients of type-2 diabetes mellitus. Results: A total of 2548 individuals were included, 71.1 percentage were male. Mean age was 37.94±12.59 years. Mean waist circumference was 90.25±13.4 5cm in males and 90.52±12.52 cm in females. Diabetes was present in 4.4 percentage of the participants and abdominal obesity in 56.6 percentage Among the male, abdominal obesity was present in 39.4 percentage and diabetes in 2.9 percentage. Out of 39.4 percentage males with abdominal obesity, 2 percentage were diabetic. Out of 38.6 percentage males with no abdominal obesity, 0.9 percentage was diabetic. Amongst the total 559 (21.1 percentage) female subjects, 17.2 percentage were having abdominal obesity and 1.4 percentage was diabetics. Among 123 (4.8 percentage) females with no abdominal obesity, 0.1 percentage was diabetic. A positive association was established between abdominal obesity and diabetes mellitus with a significant p-valve (<0.05). Conclusion: Abdominal obesity is more common in the local population of Peshawar and associated with type-2 diabetes mellitus. (author)

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help ... that is being examined to the transducer (the device used to examine the patient), as well ... is not a medical facility. Please contact your physician with specific medical ...

  17. Sequential PTA of abdominal aorta

    A case of sequential dilatation of a subtotal stenosis of the abdominal aorta in a young subject is reported. Initial and long-term success of the procedure is recorded using haemodynamic evaluation and intravenous digital subtraction angiography (IV-DSA) follow-up on an outpatient basis. In addition, the significance of biplane aortography with IV-DSA is illustrated. (orig.)

  18. Dehydration related abdominal pain (drap)

    Objective: To describe the frequency of dehydration as a medical cause of acute abdomen. Subjects and Methods: All the patients reporting with abdominal pain to the surgical outpatient department or the emergency department were reviewed in the study. The clinical findings in all these cases were studied along with the mode of their management and outcome. Results: Of all the patients presenting with abdominal pain, 3.3% (n=68) were suffering from dehydration related abdominal pain. They were predominantly males in a ratio of 8.7: 1, mostly in the 2nd and 3rd decades of their lives. All these cases were suffering from acute or chronic dehydration were provisionally diagnosed by general practitioners as 'acute abdomen' and referred for surgical consultation. Associated symptoms included vomiting in 42.6%, backache in 91.2%, headache in 95.6%, and pain in lower limbs in 97.1 % of the cases. 83.8% required indoor management with intravenous fluids. All the patients became asymptomatic with rehydration therapy. Conclusion: Dehydration is a possible cause of severe abdominal pain. There is a need to educate the general public about the benefits of adequate fluid intake. (author)

  19. Computed tomography of abdominal trauma

    Abdominal lesions following an accident or surgical interventions are becoming more frequently indications for investigations by computed tomography. Changes of spleen, liver, kidneys, pancreas, and of the retroperitoneal space are discussed. Advantages of computed tomography compared to other investigative methods are shown. (orig.)

  20. CT diagnosis of abdominal trauma

    Computed tomography (CT) findings from 95 patients with blunt abdominal trauma were evaluated. Among them, there was no false negative case. It can thus be said that if CT is negative the patient can be treated conservatively. The efficacy of CT in diagnosing injuries of various organs was also evaluated. (author)

  1. DUMPING SYNDROME IN A YOUNG-CHILD

    DEVRIES, TW; DODDEMA, JW; HEIJMANS, HSA

    1995-01-01

    We describe a 17-month-old child with dumping syndrome after plication of the right diaphragm. He presented with periods of abdominal distension and pallor, recurrent convulsions, glucosuria and refusal of Feeding. After changing the diet the symptoms disappeared. Conclusion Although dumping syndrom

  2. Heterotaxy syndrome: This is the left, right?

    Lili Huang

    2015-10-01

    Full Text Available Heterotaxy syndrome is a rare and complex disorder of the chest and abdominal organ arrangements, and presents a diagnostic challenge to the radiologist. This article describes the morphological characteristics of heterotaxy and situs abnormalities, in particular left and right atrial isomerism, and suggests an approach in evaluating the spectrum of abnormalities associated with heterotaxy syndromes, using appropriate imaging modalities.

  3. Mediterranean diet and the metabolic syndrome

    Bos, M.B.

    2009-01-01

    Mediterranean diet and the metabolic syndrome Background: The metabolic syndrome refers to a clustering of risk factors including abdominal obesity, hyperglycaemia, low HDL-cholesterol, hypertriglyceridaemia, and hypertension and it is a risk factor for diabetes mellitus type 2 and cardiovascula

  4. Heterotaxy syndrome: This is the left, right?

    Lili Huang; Belinda J. Mitchell; Savvas Andronikou; Lockhat, Zarina I; Farhana Suleman

    2015-01-01

    Heterotaxy syndrome is a rare and complex disorder of the chest and abdominal organ arrangements, and presents a diagnostic challenge to the radiologist. This article describes the morphological characteristics of heterotaxy and situs abnormalities, in particular left and right atrial isomerism, and suggests an approach in evaluating the spectrum of abnormalities associated with heterotaxy syndromes, using appropriate imaging modalities.

  5. Antagonistic implications of sarcopenia and abdominal obesity on physical performance in COPD.

    van de Bool, Coby; Rutten, Erica P A; Franssen, Frits M E; Wouters, Emiel F M; Schols, Annemie M W J

    2015-08-01

    Decreased physical performance due to loss of muscle mass (i.e. sarcopenia) is prevalent in ageing and appears more pronounced in chronic disease. A comprehensive profile of the sarcopenic phenotype in chronic obstructive pulmonary disease (COPD) is not yet available. The aim of the present study was to characterise prevalence, functional implications and predictive value of sarcopenia with or without abdominal obesity in Dutch COPD patients eligible for pulmonary rehabilitation.505 COPD patients (aged 37-87 years; 57% male) underwent assessment of lung function, body composition and physical functioning, before entering pulmonary rehabilitation. Sarcopenia was assessed by appendicular skeletal muscle index (ASMI) and abdominal obesity by android/gynoid percentage fat mass (A/G%FM) using dual energy X-ray absorptiometry.86.5% of patients were sarcopenic and showed lower physical functioning, while coexistent abdominal obesity (78.0%) resulted in higher physical functioning. Implications on endurance were less pronounced in women. The predictive value for physical functioning was higher for the "three-compartment" model (ASMI, bone mineral content and A/G%FM) than the "two-compartment" model (fat-free mass index and fat mass index) or "one-compartment" model (body mass index).In patients eligible for pulmonary rehabilitation, sarcopenia is highly prevalent in all body mass index categories and associated with impaired strength, and in men also with decreased endurance. Abdominal obesity seems to have protective effects on physical functioning. ASMI is a better predictor for physical functioning than fat-free mass index. PMID:25882802

  6. Abdominal pain - children under age 12

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe ... kinds of pain: Generalized pain or pain over more than half ...

  7. Preoperative steroid in abdominal wall reconstruction

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  8. Intra-abdominal hypertension due to heparin - induced retroperitoneal hematoma in patients with ventricle assist devices: report of four cases and review of the literature

    Spiliopoulos Sotirios

    2010-11-01

    Full Text Available Abstract Introduction Elevated intra-abdominal pressure (IAP has been identified as a cascade of pathophysiologic changes leading in end-organ failure due to decreasing compliance of the abdomen and the development of abdomen compartment syndrome (ACS. Spontaneous retroperitoneal hematoma (SRH is a rare clinical entity seen almost exclusively in association with anticoagulation states, coagulopathies and hemodialysis; that may cause ACS among patients in the intensive care unit (ICU and if treated inappropriately represents a high mortality rate. Case Presentation We report four patients (a 36-year-old Caucasian female, a 59-year-old White-Asian male, a 64-year-old Caucasian female and a 61-year-old Caucasian female that developed an intra-abdominal hypertension due to heparin-induced retroperitoneal hematomas after implantation of ventricular assist devices because of heart failure. Three of the patients presented with dyspnea at rest, fatigue, pleura effusions in chest XR and increased heart rate although b-blocker therapy. A 36-year old female (the forth patient presented with sudden, severe shortness of breath at rest, 10 days after an "acute bronchitis". At the time of the event in all cases international normalized ratio (INR was Conclusion Identifying patients in the ICU at risk for developing ACS with constant surveillance can lead to prevention. ACS is the natural progression of pressure-induced end-organ changes and develops if IAP is not recognized and treated in a timely manner. Failure to recognize and appropriately treat ACS is fatal while timely intervention - if indicated - is associated with improvements in organ function and patient survival. Means for surgical decision making are based on clinical indicators of adverse physiology, rather than on a single measured parameter.

  9. Abdominal Pain, the Adolescent and Altered Brain Structure and Function.

    Hubbard, Catherine S; Becerra, Lino; Heinz, Nicole; Ludwick, Allison; Rasooly, Tali; Wu, Rina; Johnson, Adriana; Schechter, Neil L; Borsook, David; Nurko, Samuel

    2016-01-01

    Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder of unknown etiology. Although relatively common in children, how this condition affects brain structure and function in a pediatric population remains unclear. Here, we investigate brain changes in adolescents with IBS and healthy controls. Imaging was performed with a Siemens 3 Tesla Trio Tim MRI scanner equipped with a 32-channel head coil. A high-resolution T1-weighted anatomical scan was acquired followed by a T2-weighted functional scan. We used a surface-based morphometric approach along with a seed-based resting-state functional connectivity (RS-FC) analysis to determine if groups differed in cortical thickness and whether areas showing structural differences also showed abnormal RS-FC patterns. Patients completed the Abdominal Pain Index and the GI Module of the Pediatric Quality of Life Inventory to assess abdominal pain severity and impact of GI symptoms on health-related quality of life (HRQOL). Disease duration and pain intensity were also assessed. Pediatric IBS patients, relative to controls, showed cortical thickening in the posterior cingulate (PCC), whereas cortical thinning in posterior parietal and prefrontal areas were found, including the dorsolateral prefrontal cortex (DLPFC). In patients, abdominal pain severity was related to cortical thickening in the intra-abdominal area of the primary somatosensory cortex (SI), whereas HRQOL was associated with insular cortical thinning. Disease severity measures correlated with cortical thickness in bilateral DLPFC and orbitofrontal cortex. Patients also showed reduced anti-correlations between PCC and DLPFC compared to controls, a finding that may reflect aberrant connectivity between default mode and cognitive control networks. We are the first to demonstrate concomitant structural and functional brain changes associated with abdominal pain severity, HRQOL related to GI-specific symptoms, and disease-specific measures in

  10. Abdominal Pain, the Adolescent and Altered Brain Structure and Function.

    Catherine S Hubbard

    Full Text Available Irritable bowel syndrome (IBS is a functional gastrointestinal (GI disorder of unknown etiology. Although relatively common in children, how this condition affects brain structure and function in a pediatric population remains unclear. Here, we investigate brain changes in adolescents with IBS and healthy controls. Imaging was performed with a Siemens 3 Tesla Trio Tim MRI scanner equipped with a 32-channel head coil. A high-resolution T1-weighted anatomical scan was acquired followed by a T2-weighted functional scan. We used a surface-based morphometric approach along with a seed-based resting-state functional connectivity (RS-FC analysis to determine if groups differed in cortical thickness and whether areas showing structural differences also showed abnormal RS-FC patterns. Patients completed the Abdominal Pain Index and the GI Module of the Pediatric Quality of Life Inventory to assess abdominal pain severity and impact of GI symptoms on health-related quality of life (HRQOL. Disease duration and pain intensity were also assessed. Pediatric IBS patients, relative to controls, showed cortical thickening in the posterior cingulate (PCC, whereas cortical thinning in posterior parietal and prefrontal areas were found, including the dorsolateral prefrontal cortex (DLPFC. In patients, abdominal pain severity was related to cortical thickening in the intra-abdominal area of the primary somatosensory cortex (SI, whereas HRQOL was associated with insular cortical thinning. Disease severity measures correlated with cortical thickness in bilateral DLPFC and orbitofrontal cortex. Patients also showed reduced anti-correlations between PCC and DLPFC compared to controls, a finding that may reflect aberrant connectivity between default mode and cognitive control networks. We are the first to demonstrate concomitant structural and functional brain changes associated with abdominal pain severity, HRQOL related to GI-specific symptoms, and disease

  11. ADULT ABDOMINAL WALL HERNIA IN IBADAN

    Ayandipo, O.O; Afuwape, O.O.; Irabor, D. O.; Abdurrazzaaq, A.I.

    2015-01-01

    Background: Abdominal wall hernias are very common diseases encountered in surgical practice. Groin hernia is the commonest type of abdominal wall hernias. There are several methods of hernia repair but tension-free repair (usually with mesh) offers the least recurrent rate. Aim: To describe the clinical profile of anterior abdominal wall hernias and our experience in the surgical management of identified hernias Method: The project was a retrospective study of all patients with abdominal wal...

  12. Prune belly syndrome associated with bilateral multicystic dysplastic kidneys and urethral obstruction: A case report

    Arzu Akdag

    2015-06-01

    Full Text Available Prune belly syndrome is a rare congenital disorder defined by a characteristic clinical triad: Abdominal muscle deficiency, severe urinary tract abnormalities, and bilateral cryptorchidism. We describe a preterm neonate of Prune Belly syndrome who had abdominal muscle deficiency, multicystic dysplastic kidney, urethral hypoplasia and pulmonary hypoplasia. We presented this rare case with the data gathered from the literatüre.

  13. Abdominal shotgun trauma: A case report

    Toutouzas, Konstantinos G; Larentzakis, Andreas; Drimousis, Panagiotis; Riga, Maria; Theodorou, Dimitrios; Katsaragakis, Stylianos

    2008-01-01

    Introduction One of the most lethal mechanisms of injury is shotgun wound and particularly the abdominal one. Case presentation We report a case of a 45 years old male suffering abdominal shotgun trauma, who survived his injuries. Conclusion The management of the abdominal shotgun wounds is mainly dependent on clinical examination and clinical judgment, while requires advanced surgical skills.

  14. Case report 509: Proteus syndrome

    Radiographic features of Proteus syndrome include asymmetry of limbs, partial gigantism of the hands or feet, and hemihypertrophy. The patient described (a 16-year-old male) manifested features of Proteus syndrome which is another entity in the gamut of conditions associated with localized gigantism. This entity should be suggested particularly when localized gigantism is associated with diffuse intra-abdominal lipomatosis and extensive lipomas involving the chest wall and back. (orig.)

  15. Recurrent abdominal pain: when an epileptic seizure should be suspected? Dor abdominal recorrente: quando suspeitar de crise epiléptica?

    Renata C. Franzon

    2002-09-01

    Full Text Available Recurrent episodes of abdominal pain are common in childhood. Among the diagnostic possibilities are migraine and abdominal epilepsy (AE. AE is an infrequent syndrome with paroxystic episodes of abdominal pain, awareness disturbance, EEG abnormalities and positive results with the introduction of antiepileptic drugs. We present one 6 year-old girl who had short episodes of abdominal pain since the age of 4. The pain was followed by cry, fear and occasionally secondary generalization. MRI showed tumor in the left temporal region. As a differential diagnosis, we report a 10 year-old boy who had long episodes of abdominal pain accompanied by blurring of vision, vertigo, gait ataxia, dysarthria, acroparesthesias and vomiting. He received the diagnosis of basilar migraine. In our opinion, AE is part of a large group (partial epilepsies and does not require a special classification. Pediatric neurologists must be aware of these two entities that may cause abdominal pain.Episódios recorrentes de dor abdominal são freqüentes na infância e entre as causas neurológicas há migrânea e epilepsia abdominal (EA. EA é uma síndrome que consiste de episódios paroxísticos de dor abdominal associada à alteração de consciência, anormalidades eletrencefalográficas e boa resposta à terapia anticonvulsivante. Apresentamos uma menina de 6 anos que tinha desde os 4 anos episódios de curta duração de dor abdominal, seguidos por choro, medo e ocasional generalização secundária. A RM mostrou a presença de um tumor em região temporal esquerda. Como diagnóstico diferencial, apresentamos um menino de 10 anos que há 12 meses referia episódios de dor abdominal de longa duração acompanhados por turvação visual, vertigem, marcha atáxica, disartria, acroparestesia e vômito, recebendo posteriormente o diagnóstico de migrânia basilar. Em nossa opinião, EA faz parte de um grande grupo (epilepsias parciais e não requer uma classificação especial

  16. The therapeutic effect of carbogaseous natural mineral waters in the metabolic syndrome

    Cinteza Delia; Munteanu Constantin; Poenaru Daniela; Munteanu Diana; Petrusca Irina; Dumitrascu Dan

    2013-01-01

    Metabolic syndrome (syndrome X or insulin resistance syndrome) is a complex of metabolic disturbances that increase the risk of developing cardiovascular disease. Entity includes: dyslipidemia (altered lipid profile, with increasing levels of serum triglycerides and low serum levels of HDL-cholesterol, which promotes the development of atherosclerosis), high blood sugar (diabetes type II) or increased insulin resistance, hypertension, abdominal obesity syndrome, proinflammatory, prothrombotic...

  17. 间室内压监测与症状体征对间室综合征早期诊断的相关性研究%A study on the correlation of ICP monitoring and signs and symptoms in early diagnosis of compartment syndrome

    张文玺; 方加虎; 凌为其

    2013-01-01

    背景:间室综合征(CS)临床上偶有发生,根据症状体征结合间室内压(ICP)测定进行判断更安全,对于缺乏ICP测定设备的情况下,症状体征不失为简单且重要的判断方法,但难以量化。  目的:分析ICP与症状体征评分在CS早期诊断中的相关性。  方法:对符合纳入标准的80例患者进行症状体征评分的同时进行ICP测量,先由专科医师记录症状体征并按评分标准进行评分,记录总分值作为评分组;再采用CYY-1型自动筋膜压测量仪对前臂与小腿肿胀进行ICP测量,计算ΔP(舒张压-ICP)作为测压组。测压组与评分组采用自身对照。采用单因素线性回归分析,判断症状体征评分与ΔP的相关系数是否存在线性相关;采用配对卡方检验,分析通过症状体征评分和ΔP判断发生CS的数量是否存在统计学差异。结果:80例患者符合纳入标准,并进行为期1周的临床观察,其中6例的症状体征评分>10分且ΔP<4 kPa,一致判断为CS,并予以切开减压处理,症状体征评分与ΔP存在线性关系(r=0.822);症状体征评分和ΔP判断发生CS的数量分别为6例和14例,相比较有统计学差异(P=0.008),说明两种判断方法对CS的诊断存在一定区别,以ΔP判断可以发现更多存在潜在危险的患者。  结论:采用症状体征评分进行CS判定存在一定风险性;采用ΔP<4 kPa作为切开减压标准极少出现CS未检出的情况。因此,以ΔP<4 kPa作为切开减压标准的同时仍需要结合症状体征进行综合考虑。%Background:Compartment syndrome (CS) occurs occasionally in clinics. It is safer to diagnose it according to symptoms and signs with the combination of intra-compartmental pressure (ICP) determination. But if there is a lack of ICP measurement equipment, judging by signs and symptoms may be a simple and important method, but it is difficult to

  18. Speciation of uranium in environmental relevant compartments

    In the past, the chemistry of uranium was focused on its mining and milling for production of high pure uranium compounds as initial matter of reactor fuel elements for energy production and breeding of plutonium for weapons production. In this sense, the recovery of uranium and plutonium from the used reactor fuel elements was also technical realized. The increasing input of uranium into bio-sphere by mining and milling and industrial processes like production of cement, fossil fuels, and fertilizers has led to the realization of the importance of uranium environmental chemistry. For a better assessment of radiotoxicity and transport along the food chain knowledge about the chemistry of uranium is needed in all involved compartments. Starting from uranium content in geo- and bio-systems, about the determination of chemical behavior - the speciation of uranium - is reported in selected environmental compartments like seepage waters coming from mine tailings, different kinds of bacteria living in uranium contaminated soils, and relevant forage plants growing on these soils. For uranium speciation determination direct non-invasive methods are used like various laser spectroscopic methods, and X-ray absorption spectroscopy with synchrotron radiation source, The results obtained by spectroscopic methods showed that the speciation of uranium is dominated in surface waters by uranyl-carbonate complexes in opposite to the speciation in bacteria and plants. In these compartments the speciation is dominated by binding of uranium on carboxylic and phosphorous containing functional groups. It was shown, that in the investigated systems the speciation strongly depends on different physical chemical parameters like ionic strength, kind and amount of ligands, pH, Eh e.g. In experiments with living organisms it is necessary to characterize the state of the bio-system in dependence of the used parameters to compare the obtained results (ratio of dead or living cells of bacteria

  19. Intra-abdominal metastasis of an intracranial germinoma via ventriculo-peritoneal shunt in a 13-year-old female.

    Murray, Matthew J; Metayer, Lucy E; Mallucci, Conor L; Hale, Juliet P; Nicholson, James C; Kirollos, Ramez W; Burke, G A Amos

    2011-12-01

    A 13-year-old patient presented with massive intra-abdominal metastasis and spontaneous acute tumour lysis syndrome, 17-months after VP shunt placement for metastatic pineal germinoma treated with cranio-spinal-irradiation. Hyperhydration/rasburicase improved renal function, allowing chemotherapy with subsequent surgery. The patient remains event-free 34-months later. Risk of intra-abdominal metastasis from VP shunts is discussed. PMID:21501064

  20. Multiple bowel perforation and necrotising fasciitis secondary to abdominal liposuction in a patient with bilateral lumbar hernia

    Vincent Delliere; Bertheuil, N.; Harnois, Y.; S Thienot; Gerard, M.; Robert, M; Watier, E.

    2014-01-01

    We present a rare complication of abdominal liposuction: bowel perforation and necrotizing fasciitis. Because of bilateral lumbar hernia, a 56-year-old woman had caecum and descending colon perforation during lipoplasty. She had septic shock syndrome at her admission. The authors treated this complex wound with several debridement, omental flap, NPWT and split-thickness skin graft. The incidence of abdominal wall perforation with visceral injury is 14 in 100,000 liposuctions performed. There ...

  1. [Mesenteric traction syndrome.

    Krohn, Paul Suno; Ambrus, Rikard; Zaar, Morten; Secher, Niels H; Svendsen, Lars Bo

    2014-02-17

    Mesenteric traction syndrome (MTS) manifests in 58-87% of patients undergoing upper abdominal surgery and is characterised by a triad of hypotension, tachycardia, and flushing. Prostacyclin is released from the gut mucosa following intestinal eventration and cyclooxygenase antagonists prevent the development of MTS. Also the use of remifentanil appears to increase the incidence of MTS and hypotension is aggravated by epidural analgesia. Yet, prostacyclin may be important for maintaining microcirculation within the splanchnic area and preserve its mucosal barrier. PMID:25350303

  2. Distal arthrogryposis syndrome

    Kulkarni K

    2008-01-01

    Full Text Available A 5-month-old male infant presented with weak cry, decreased body movements, tightness of whole body since birth, and one episode of generalized seizure on day 4 of life. He was born at term by elective caesarian section performed for breech presentation. The child had failure to thrive, contractures at elbow and knee joints, hypertonia, microcephaly, small mouth, retrognathia, and camptodactyly. There was global developmental delay. Abdominal examination revealed umbilical and bilateral inguinal hernia. Visual evoked response and brainstem evoked response audiometry were abnormal. Nerve conduction velocity was normal. Magnetic resonance imaging of brain revealed paucity of white matter in bilateral cerebral hemispheres with cerebellar and brain stem atrophy. The differential diagnoses considered in the index patient were distal arthrogryposis (DA syndrome, cerebroculofacioskeletal syndrome, and Pena Shokier syndrome. The index patient most likely represents a variant of DA: Sheldon Hall syndrome.

  3. Susceptibility variants for waist size in relation to abdominal, visceral, and hepatic adiposity in postmenopausal women.

    Lim, Unhee; Ernst, Thomas; Wilkens, Lynne R; Albright, Cheryl L; Lum-Jones, Annette; Seifried, Ann; Buchthal, Steven D; Novotny, Rachel; Kolonel, Laurence N; Chang, Linda; Cheng, Iona; Le Marchand, Loïc

    2012-07-01

    Genome-wide association studies have identified common genetic variants that can contribute specifically to the risk of abdominal adiposity, as measured by waist circumference or waist-to-hip ratio. However, it is unknown whether these genetic risk factors affect relative body fat distribution in the abdominal visceral and subcutaneous compartments. The association between imaging-based abdominal fat mass and waist-size risk variants in the FTO, LEPR, LYPLAL1, MSRA, NRXN3, and TFAP2B genes was investigated. A cross-sectional sample of 60 women was selected among study participants of The Multiethnic Cohort, who were aged 60 to 65 years, of European or Japanese descent, and with a body mass index (calculated as kg/m(2)) between 18.5 and 40. Dual-energy x-ray absorptiometry and abdominal magnetic resonance imaging scans were used to measure adiposity. After adjustments for age, ethnicity, and total fat mass, the FTO variants showed an association with less abdominal subcutaneous fat and a higher visceral-to-subcutaneous abdominal fat ratio, with the variant rs9941349 showing significant associations most consistently (P=0.003 and 0.03, respectively). Similarly, the LEPR rs1137101 variant was associated with less subcutaneous fat (P=0.01) and a greater visceral-to-subcutaneous fat ratio (P=0.03) and percent liver fat (P=0.007). MSRA rs545854 variant carriers had a lower percent of leg fat. Our findings provide initial evidence that some of the genetic risk factors identified for larger waist size might also contribute to disproportionately greater intra-abdominal and liver fat distribution in postmenopausal women. If replicated, these genetic variants can be incorporated with other biomarkers to predict high-risk body fat distribution. PMID:22889634

  4. Intestinal contrasting in abdominal CT

    In 56 patients undergoing abdominal CT the gastro-intestinal tract was defined by negative contrast instead of the conventional positive contrast from an iodine containing contrast medium. The contrast material was a 2 1/2% mannitol solution and was used for filling the rectum. Filling of the gastro-intestinal tract was of similar quality to that obtained with positve contrast media. The number of artifacts due to high contrast boundaries was slightly greater with the negative contrast than if would have been with positive contrast. Differentiation of the gastro-intestinal tract from other abdominal organs was equally good for both methods. The negative contrast method was poor in diagnosing cystic tumours but proved much better than positive contrast for evaluating the wall of the gastro-intestinal tract. (orig.)

  5. Sonography of blunt abdominal trauma

    Sonographic examination of the abdomen after blunt abdominal trauma represents a rapid and effective diagnostic method without bothering the patient. It has proved its value not only in the confirmation or exclusion of free fluid in the abdomen caused by liver of spleen rupture, but also in such cases actually it replaces peritoneal lavage or exploratory laparotomy. It is also qualified for diagnosis of intraparenchymal or subcapsular hemorrhages, intraperitoneal as well as retroperitoneal and for follow up. In particualr delayed bleedings including the risk of a retarded organ rupture can be detected early. A failure rate of 1.4% in 282 sonographically examined cases of blunt abdominal trauma further confirms the reliability of this method. (orig.)

  6. Acupuncture Treatment of Abdominal Pain

    胡金生

    2002-01-01

    @@ Case History Mr. Li, a university student aged 23 years, paid his first visit on July 16, 2001, with the chief complaint of abdominal pain for one day. The patient stated that one day before when it happened to be the weekend, he got abdominal pain after supper, which went worse gradually and caused him to roll all over in bed. The pain was slightly alleviated half an hour later after he had taken some pain killers. Upon inquiry, the patient said that because of their newly graduation from the university, he and his classmates were so excited that they went to have a sumptuous lunch with alcoholic drinks. And in the evening he ate again a delicious supper cooked for him by his mother, after which he continued to have some fruit and dessert.

  7. CT of abdominal blunt trauma

    We studied CT findings and interventional radiology including therapeutic procedures in 43 cases with abdominal blunt trauma, retrospectively. All of parenchymal organ's injuries, and injuries of duodenum and retroperitoneum were correctly diagnosed by CT. In 14 cases with only hemoperitoneum or no positive findings on CT, 4 cases were jejunal perforations, and remaining 10 cases were conservatively treated and relieved. We have to take care that the similar CT findings include the opposite results to need surgery and not. (author)

  8. [A case of abdominal wall actinomycosis].

    Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

    2015-04-01

    Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodeficiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

  9. Gap junctional communication compartments in the Drosophila wing disk.

    Weir, M P; Lo, C.W.

    1982-01-01

    We have examined the gap junctional communication properties of cells in the wing imaginal disk of Drosophila, using intracellular injection of the fluorescent dye tracer Lucifer Yellow. The cell-to-cell passage of Lucifer Yellow is restricted at a boundary line that divides the wing disk into halves. We refer to each half as a "communication compartment" because there is a high level of gap junctional exchange within a compartment and much lower exchange between compartments. Comparison of t...

  10. Abdominal wound closure: current perspectives

    Williams ZF

    2015-12-01

    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  11. Acute Abdominal Pain in Children.

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  12. Molecular Characterization of Plant Prevacuolar and Endosomal Compartments

    2007-01-01

    Prevacuolar compartments (PVCs) and endosomal compartments are membrane-bound organelles mediating protein traffic to vacuoles in the secretory and endocytic pathways of plant cells. Over the years, great progress has been made towards our understanding in these two compartments in plant cells. In this review, we will summarize our contributions toward the identification and characterization of plant prevacuolar and endosomal compartments. Our studies will serve as important steps in future molecular characterization of PVC biogenesis and PVC-mediated protein trafficking in plant cells.

  13. Visceral hypersensitivity in Irritable Bowel Syndrome:pathophysiological mechanisms

    Kerckhoffs, A.P.M.

    2009-01-01

    Irritable Bowel Syndrome (IBS) is a functional bowel disease characterized by abdominal pain or discomfort associated with a disordered defecation. No unique pathophysiological mechanism has been identified. It is most likely a multifactorial disease involving alterations in intestinal microbiota co

  14. Urgent Abdominal Re-Explorations

    Peskersoy Mustafa

    2006-04-01

    Full Text Available Abstract Background Treatment of a number of complications that occur after abdominal surgeries may require that Urgent Abdominal Re-explorations (UARs, the life-saving and obligatory operations, are performed. The objectives of this study were to evaluate the reasons for performing UARs, outcomes of relaparotomies (RLs and factors that affect mortality. Methods Demographic characteristics; initial diagnoses; information from and complications of the first surgery received; durations and outcomes of UAR(s performed in patients who received early RLs because of complicated abdominal surgeries in our clinic between 01.01.2000 and 31.12.2004 were investigated retrospectively. Statistical analyses were done using the chi-square and Fisher exact tests. Results Early UAR was performed in 81 out of 4410 cases (1.8%. Average patient age was 50.46 (13–81 years with a male-to-female ratio of 60/21. Fifty one (62.96% patients had infection, 41 (50.61% of them had an accompanying serious disease, 24 (29.62% of them had various tumors and 57 (70.37% patients were operated under emergency conditions during first operation. Causes of urgent abdominal re-explorations were as follows: leakage from intestinal repair site or from anostomosis (n:34; 41.97%; hemorrhage (n:15; 18.51%; intestinal perforation (n:8; 9.87%; intraabdominal infection or abscess (n:8; 9.87%; progressive intestinal necrosis (n:7; 8.64%; stomal complications (n:5; 6.17%; and postoperative ileus (n:4; 4.93%. Two or more UARs were performed in 18 (22.22% cases, and overall mortality was 34.97% (n:30. Interval between the first laparotomy and UAR averaged as 6.95 (1–20 days, and average hospitalization period was 27.1 (3–78 days. Mortality rate was found to be higher among the patients who received multiple UARs. The most common (55.5% cause of mortality was sepsis/multiple organ failure (MOF. The rates for common mortality and sepsis/MOF-dependent mortality that occured following UAR were

  15. A case of McKusick-Kaufman syndrome

    Se Hyung Son; Yoon Joo Kim; Eun Sun Kim; Ee Kyung Kim; Han Suk Kim; Beyong Il Kim; Jung Hwan Choi

    2011-01-01

    McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy whi...

  16. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group).

    Meyers, W C; Foley, D P; Garrett, W E; Lohnes, J H; Mandlebaum, B R

    2000-01-01

    The purpose of this study was to gain insight into the pathophysiologic processes of severe lower-abdominal or inguinal pain in high-performance athletes. We evaluated 276 patients; 175 underwent pelvic floor repairs. Of the 157 athletes who had not undergone previous surgery, 124 (79%) participated at a professional or other highly competitive level, and 138 patients (88%) had adductor pain that accompanied the lower-abdominal or inguinal pain. More patients underwent related adductor releases during the later operative period in the series. Evaluation revealed 38 other abnormalities, including severe hip problems and malignancies. There were 152 athletes (97%) who returned to previous levels of performance. The syndrome was uncommon in women and the results were less predictable in nonathletes. A distinct syndrome of lower-abdominal/adductor pain in male athletes appears correctable by a procedure designed to strengthen the anterior pelvic floor. The location and pattern of pain and the operative success suggest the cause to be a combination of abdominal hyperextension and thigh hyperabduction, with the pivot point being the pubic symphysis. Diagnosis of "athletic pubalgia" and surgery should be limited to a select group of high-performance athletes. The consideration of other causes of groin pain in the patient is critical. PMID:10653536

  17. Metabolic Syndrome – Epidemiological Problem?

    Gierach, Marcin; Junik, Roman

    2013-01-01

    The main components of the metabolic syndrome (MetS) are abdominal obesity, hypertension, lipid disorders such as aterogenic dyslipidemia and carbohydrates disorders such as impaired fasting glucose or diabetes mellitus type 2 The first definition of MetS was described by Reaven in 1988 and was named as syndrome X. In the United States of America, the metabolic syndrome affects about 25 % of US adults. In Poland, data based on NATPOL PLUS study, according to NCEP-ATP III criteria, metabolic s...

  18. Adrenal mass in patients who underwent abdominal computed tomography examination

    Hassan Al-Thani

    2015-01-01

    Full Text Available Background: Adrenal masses are usually discovered incidentally (IAM during abdominal computed tomography (CT. Aims: We aimed to describe the prevalence, management, and outcome of incidentally discovered adrenal mass on radiological investigation. Materials and Methods: A retrospective analysis was conducted to look for IAM identified by abdominal CT performed for other reasons between 2004 and 2008 and were followed for 4 years. IAM patients with known malignancy or clinically evident adrenal disease or overt disease originally missed due to insufficient clinical examination were excluded. Results: A total of 13,115 patients underwent abdominal CT, of which 136 were identified with adrenal mass (69 males and 67 females. Overall, 84 patients had benign IAM and six had primary adrenal carcinoma (all had tumor size ≥4 cm and five were males. Hormonal evaluation was performed in 80 cases, which revealed hypersecretion in 10 cases (six had Conn′s syndrome and four had pheochromocytoma. Males had higher frequency of right-sided IAMs; whereas, left-sided IAM swere more common among females (P = 0.02. Seven patients underwent surgery and all were males (one Conn′s syndrome, one pheochromocytoma, three primary adrenal adenocarcinoma, one benign nonfunctional adenoma, and one metastatic tumor. Only one patient died due to brain metastasis. Conclusion: The overall prevalence of adrenal incidentaloma is 1% in Qatar. Unfortunately, hormonal evaluation, surgical referral, and follow-up are not appropriate in this study. Moreover, screening of IAM warrants more attention to rule out malignancy. This work could be of value as a local auditing for the current management.

  19. What is metabolic syndrome, and why are children getting it?

    Weiss, Ram; Bremer, Andrew A.; Lustig, Robert H.

    2013-01-01

    Metabolic syndrome comprises a cluster of cardiovascular risk factors (hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity) that occur in obese children. However, metabolic syndrome can also occur in lean individuals, suggesting that obesity is a marker for the syndrome, not a cause. Metabolic syndrome is difficult to define, due to its nonuniform classification and reliance on hard cutoffs in the evaluation of disorders with non-Gaussian distributions. Defining the ...

  20. Engrailed: a gene controlling compartment and segment formation in Drosophila.

    Kornberg, T

    1981-01-01

    A total of 58 mutations at the engrailed locus were isolated. Analysis suggests that this genetic locus is necessary for survival but required only in the cells of the posterior compartments. Inactivation of the engrailed locus renders the animal incapable of maintaining the separation between the groups of cells that constitute either the compartments that subdivide each segment or the individual segments themselves.

  1. 46 CFR 169.625 - Compartments containing diesel machinery.

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Compartments containing diesel machinery. 169.625... SCHOOL VESSELS Machinery and Electrical Ventilation § 169.625 Compartments containing diesel machinery. (a) Spaces containing machinery must be fitted with adequate dripproof ventilators, trunks,...

  2. 14 CFR 29.787 - Cargo and baggage compartments.

    2010-01-01

    ... emergency landing conditions of § 29.561. (b) There must be means to prevent the contents of any compartment...) Under the emergency landing conditions of § 29.561, cargo and baggage compartments must— (1) Be... any of the escape facilities provided for use after an emergency landing; or (2) Have...

  3. 14 CFR 27.787 - Cargo and baggage compartments.

    2010-01-01

    ... emergency landing conditions of § 27.561. (b) There must be means to prevent the contents of any compartment...) Under the emergency landing conditions of § 27.561, cargo and baggage compartments must— (1) Be... any of the escape facilities provided for use after an emergency landing; or (2) Have...

  4. 14 CFR 91.613 - Materials for compartment interiors.

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Materials for compartment interiors. 91.613 Section 91.613 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... compartment interiors. (a) No person may operate an airplane that conforms to an amended or supplemental...

  5. FULL TERM EXTRAUTERINE ABDOMINAL PREGNANCY

    Neetu

    2014-02-01

    Full Text Available Extrauterine abdominal pregnancy is extremely rare and is frequently missed during antenatal care, despite the routine use of obstetrics ultrasound. A 23 year old primigravida at 39 weeks of gestation was admitted to the department on December 2 , 2012, in routine hour with transverse lie with oligohydramnios. On examination her vitals and laboratory investigation were within normal limits . One of the ultrasonographic scanning done by radiologist at 35 wk. 3 days gestation demonstrated a single live intrauterine fetus of CGA 33 wk. 1 day with transverse lie , fundal gr II placenta and AFI - 10 cm. Ultrasonography done at the department on the day of admission demonstrated single live intrauterine fetus with transverse lie and AFI - 3.8 cm and EFW 2.4 Kg and placenta was right anterior.. She was planned for elective caesarean section on account of transverse lie and oligohydramnios at term. At laparotomy the following findings were made: Secondary abdominal pregnancy arising from right tubal ectopic rupture and making pseudogesta tional sac with meconium stained liquor. Omentum , right tube and ovary were adhered to sac. The uterus and left tube and ovary were healthy and normal . Other abdominal organs were normal. A 1.5 Kg live male baby with good Apgar score and incompletely formed mandible extracted from pseudo gestational sac. There was significant bleeding from pseudogestational sac and patient went in shock during intraoperative period. One unit whole blood transfused during intraoperative period. Placenta was adherent to the pseudogestational sac so Psudogestational sac was removed with placenta in situ and right sided salpingo - o ophrectomy was also done due to their adherence. Hemostasis was secured. The patient and baby progressed well and were discharged on the seventh postoperative day

  6. Compartment in vertical flow reactor for ferruginous mine water

    Hur, Won; Cheong, Young-Wook; Yim, Gil-Jae; Ji, Sang-Woo; Hong, Ji-Hye

    2014-05-01

    Mine effluents contain varying concentrations of ferrous ion along with other metal ions. Fe(II) that quickly oxidizes to form precipitates in the presence of oxygen under net alkaline or neutral conditions. Thus, passive treatment methods are designed for the mine water to reside in an open containment area so as to allow simultaneous oxidation and precipitation of Fe(II), such as in a lagoon or an oxidation pond. A vertical flow reactor (VFR) was also suggested to remediate ferruginous mine drainage passing down through an accreting bed of ochre. However, VFR has a limited operation time until the system begins to overflow. It was also demonstrated that two-compartment VFR has a longer operation time than single compartment VFR of same size. In this study, a mathematical model was developed as a part of efforts to explore the operation of VFR, showing dynamic changes in head differences, ochre depth and Fe(II)/Fe(III) concentration in the effluent flow. The analysis shows that Fe(II) oxidation and ochre formation should be balanced with permeability of ochre bed to maximize VFR operation time and minimize residual Fe(II) in the effluent. The model demonstrates that two compartment VFR can have a longer operation time than a single-compartment VFR and that an optimum compartment ratio exists that maximize VFR operation time. Accelerated Fe(II) oxidation significantly affects the optimum ratio of compartment area and reduced residual Fe(II) in the effluent. VFR operation time can be significantly prolonged by increasing the rate of ochre formation not by accelerated Fe(II) oxidation. Taken together, ochre forms largely in the first compartment while overflowed mine water with reduced iron contents is efficiently filtered in the second compartment. These results provide us a better understanding of VFR operation and optimum design criteria for maximum operation time in a two-compartment VFR. Rapid ochre accretion in the first compartment maintains constant hydraulic

  7. Radiography of the abdominal cavity

    Radiography is a very important part of the diagnostic procedure in many small animal diseases. Technically perfect X-rays are essential for the exact diagnosis. The general appearance of the abdominal cavity should be evaluated at first, e.g. the overall contrast and the definition of the visualized organs. Then particular attention should be paid, if there is any peritoneal effusion or free air in the peritoneal cavity. Subsequently each radiographically visible organ has to be evaluated for its position, size, shape and radiographic density

  8. Screening for Abdominal Aortic Aneurysm

    Linné, Anneli

    2014-01-01

    Abdominal Aortic Aneurysm (AAA) is a common disease with a prevalence of 1.5-2.0% in 65-year old men in Sweden. The risk of having AAA is increased with smoking, high age, family history of AAA and cardiovascular disease. Women have a lower prevalence (0.5%) and develop AAA later in life. An AAA seldom gives any symptom prior to rupture. Untreated rupture is associated with 100% mortality, while surgically treated rupture is associated with 25-70% mortality. Prophylactic sur...

  9. Abdominal manifestations of autoimmune disorders

    Full text: Immunoglobulin G4-related disease was recognized as a systemic disease since various extrapancreatic lesions were observed in patients with autoimmune pancreatitis (AIP). The real etiology and pathogenesis of IgG4-RD is still not clearly understood. Moreover the exact role of IgG4 or IgG4-positive plasma cells in this disease has not yet been elucidated. only some inconsistent biological features such as hypergammaglobulinemia or hypocomplementemia support the autoimmune nature of the disease process. various names have been ascribed to this clinicopathological entity including IgG4-related sclerosing disease, IgG4-related systemic sclerosing disease, IgG4-related disease, IgG4-related autoimmune disease, hyper-IgG4 disease and IgG4-related systemic disease. The extrapancreatic lesions of IgG4-RD also exhibit the same characteristic histologic features including dense lymphoplasmacytic infiltrate, massive storiform fibrosis, and obliterative phlebitis as seen in IgG4-related pancreatitis. Abdominal manifestations include the following organs/systems: Bile ducts: Sclerosing cholangitis; Gallbladder and liver: Acalculous sclerosis cholecytitis with diffuse wall thickening; hepatic inflammatory pseudotumorts; Kidneys: round or wedge-shaped renal cortical nodules, peripheral cortical; lesions, mass like lesions or renal pelvic involvement; Prostate, urethra, seminal vesicle, vas deferens, uterine cervix; Autoimmune prostatitis; Retroperitoneum: Retroperitoneal fibrosis. thin or mildly thick homogeneous soft tissue lesion surrounding the abdominal aorta and its branches but also bulky masses causing hydronephroureterosis; Mesentery: Sclerosing mesenteritis usually involving the root of the mesentery; Bowel: Inflammatory bowel diseases mimicking Crohn’s disease or ulcerative colitis. various types of sclerosing nodular lesions of the bowel wall; Stomach: Gastritis, gastric ulcers and focal masses mimicking submucosal tumor; omentum: Infiltration mimicking

  10. Cannabinoid hyperemesis syndrome.

    Galli, Jonathan A; Sawaya, Ronald Andari; Friedenberg, Frank K

    2011-12-01

    Coinciding with the increasing rates of cannabis abuse has been the recognition of a new clinical condition known as Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting, and frequent hot bathing. Cannabinoid Hyperemesis Syndrome occurs by an unknown mechanism. Despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS. Tetrahydrocannabinol, cannabidiol, and cannabigerol are three cannabinoids found in the cannabis plant with opposing effects on the emesis response. The clinical course of Cannabinoid Hyperemesis Syndrome may be divided into three phases: prodromal, hyperemetic, and recovery phase. The hyperemetic phase usually ceases within 48 hours, and treatment involves supportive therapy with fluid resuscitation and anti-emetic medications. Patients often demonstrate the learned behavior of frequent hot bathing, which produces temporary cessation of nausea, vomiting, and abdominal pain. The broad differential diagnosis of nausea and vomiting often leads to delay in the diagnosis of Cannabinoid Hyperemesis Syndrome. Cyclic Vomiting Syndrome shares several similarities with CHS and the two conditions are often confused. Knowledge of the epidemiology, pathophysiology, and natural course of Cannabinoid Hyperemesis Syndrome is limited and requires further investigation. PMID:22150623

  11. On the abdominal pressure volume relationship

    Mulier, Jan Paul; Dillemans, Bruno; Crombach, Mark; Missant, Carlo; Sels, Annabel

    2009-01-01

    Abstract: During insufflation of the abdomen to create a pneumoperitoneum for laparoscopy, both intra abdominal pressure and insufflated volume can be measured and are used to calculate the abdominal pressure-volume relationship. First, an accurate, linear relationship was identified using a mathematical model with an elastance, E, or its reciprocal the compliance C and with a pressure at zero volume, PV0. This function was stable and could be used to describe the abdominal characteristics of...

  12. TODDLER WITH RECURRENT ABDOMINAL PAIN: MIGRAINE?

    Amit; Vaishali

    2014-01-01

    Abdominal migraine is a migraine variant, causing chronic idiopathic recurrent abdominal pain in 4-15% of children. It is usually seen between the ages of seven to twelve years and is more common in girls, with peak prevalence at the age of ten years. We report a 3 year old girl suffering from recurrent abdominal pain since 1½ years of age, who underwent extensive investigations as well as diagnostic laparotomy with appendectomy, and was ultimately diagnosed to have abdomi...

  13. Ankle impingement syndromes

    Soft-tissue and osseous impingement syndromes can be an important cause of chronic ankle pain, particularly in the professional athlete. The classification of ankle impingement syndromes is based to their anatomical location around the tibiotalar joint. The most important impingement syndromes are anterolateral, anterior and posterior impingement with more recent studies describing posteromedial and anteromedial impingement. Usually conventional radiography is the first imaging technique to be performed as it allows assessment of potential bone abnormalities, particularly in anterior and posterior joint compartments. Computed tomography (CT) only plays a role in the assessment of the posterior impingement. Magnetic resonance (MR) imaging is regarded as the modality of choice as it is able to demonstrate both osseous and soft tissue changes, such as bone marrow edema, capsular and ligametous thickening, and localized synovitis. (orig.)

  14. TODDLER WITH RECURRENT ABDOMINAL PAIN: MIGRAINE?

    Amit

    2014-10-01

    Full Text Available Abdominal migraine is a migraine variant, causing chronic idiopathic recurrent abdominal pain in 4-15% of children. It is usually seen between the ages of seven to twelve years and is more common in girls, with peak prevalence at the age of ten years. We report a 3 year old girl suffering from recurrent abdominal pain since 1½ years of age, who underwent extensive investigations as well as diagnostic laparotomy with appendectomy, and was ultimately diagnosed to have abdominal migraine. She responded well to the prophylactic drug Flunarizine.

  15. Abdominal ultrasound in AIDS patients

    To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,

  16. The Neonate with Abdominal Mass

    M. Bajoghli

    2008-01-01

    Full Text Available Neonatal abdominal masses have broad spectrum of pathology, ranging from small lesions found incidentally to large masses occupying the entire of peritoneal cavity. These tumors are benign to malignant, and from unilocular cysts to complex solid lesions. Many of these lesions identified and will treat before delivery. Others are discovered during routine examination. These lesions may be life threatening, or cause persistent morbidity. Some of these have no sequel."nDiagnosis began with history. Characteristic of the mass which must be note include location, size, shape, texture, mobility and tenderness. Other findings should be in mind to find out nature of mass, for example hypoplasia of chest wall with oligohydramnios due to GU tract obstruction (potter sequwnce, a bulging hymen due to hydrometrocolpus, skin metastasis due to neuroblastoma. Radiography is the next step that shows organomegaly and calcification. Next step is US which is an excellent screening tool. CT and MRI are occasionally indicated."nThe purpose of this presentation is to review the diagnosis of abdominal masses in neonates.

  17. Percutaneous drainage of abdominal abcess

    Men, Sueleyman E-mail: suleyman.men@deu.edu.tr; Akhan, Okan; Koeroglu, Mert

    2002-09-01

    The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that have been described to drain pelvic abscesses include transrectal or transvaginal approach with sonographic guidance, a transgluteal, paracoccygeal-infragluteal, or perineal approach through the greater sciatic foramen with CT guidance. Both the renal and the perirenal abscesses are amenable to percutaneous drainage. Percutaneous drainage provides an effective and safe alternative to more invasive surgical drainage in most patients with psoas abscesses as well.

  18. Beals Syndrome

    ... Boards & Staff Annual Report & Financials Contact Us Donate Marfan & Related Disorders What is Marfan Syndrome? What are ... the syndrome. How does Beals syndrome compare with Marfan syndrome? People with Beals syndrome have many of ...

  19. Gated entry into the ciliary compartment.

    Takao, Daisuke; Verhey, Kristen J

    2016-01-01

    Cilia and flagella play important roles in cell motility and cell signaling. These functions require that the cilium establishes and maintains a unique lipid and protein composition. Recent work indicates that a specialized region at the base of the cilium, the transition zone, serves as both a barrier to entry and a gate for passage of select components. For at least some cytosolic proteins, the barrier and gate functions are provided by a ciliary pore complex (CPC) that shares molecular and mechanistic properties with nuclear gating. Specifically, nucleoporins of the CPC limit the diffusional entry of cytosolic proteins in a size-dependent manner and enable the active transport of large molecules and complexes via targeting signals, importins, and the small G protein Ran. For membrane proteins, the septin protein SEPT2 is part of the barrier to entry whereas the gating function is carried out and/or regulated by proteins associated with ciliary diseases (ciliopathies) such as nephronophthisis, Meckel–Gruber syndrome and Joubert syndrome. Here, we discuss the evidence behind these models of ciliary gating as well as the similarities to and differences from nuclear gating. PMID:26472341

  20. Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis

    Juvenal da Rocha Torres Neto

    2007-09-01

    Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic

  1. Stochastic Turing Patterns: Analysis of Compartment-Based Approaches

    Cao, Yang

    2014-11-25

    © 2014, Society for Mathematical Biology. Turing patterns can be observed in reaction-diffusion systems where chemical species have different diffusion constants. In recent years, several studies investigated the effects of noise on Turing patterns and showed that the parameter regimes, for which stochastic Turing patterns are observed, can be larger than the parameter regimes predicted by deterministic models, which are written in terms of partial differential equations (PDEs) for species concentrations. A common stochastic reaction-diffusion approach is written in terms of compartment-based (lattice-based) models, where the domain of interest is divided into artificial compartments and the number of molecules in each compartment is simulated. In this paper, the dependence of stochastic Turing patterns on the compartment size is investigated. It has previously been shown (for relatively simpler systems) that a modeler should not choose compartment sizes which are too small or too large, and that the optimal compartment size depends on the diffusion constant. Taking these results into account, we propose and study a compartment-based model of Turing patterns where each chemical species is described using a different set of compartments. It is shown that the parameter regions where spatial patterns form are different from the regions obtained by classical deterministic PDE-based models, but they are also different from the results obtained for the stochastic reaction-diffusion models which use a single set of compartments for all chemical species. In particular, it is argued that some previously reported results on the effect of noise on Turing patterns in biological systems need to be reinterpreted.

  2. An atypical presentation of small bowel obstruction and perforation secondary to sporadic synchronous intra-abdominal desmoid tumours

    Abdalla, Sala; Wilkinson, Michelle; Wilsher, Mark; Uzkalnis, Aleksandras

    2016-01-01

    Introduction Desmoid tumours (DTs) are rare, soft tissue tumours which account for 0.03% of all neoplasms. They are characteristically locally invasive but do not metastasize. There is frequent association with females of reproductive age, a history of abdominal surgery or trauma and a family history of fibromatoses. Intra-abdominal DTs are infrequently sporadic and more commonly associated with inherited disorders such as familial adenomatous polyposis (FAP), attenuated FAP and Gardener’s syndrome. Presentation of case The authors report a rare case of small bowel obstruction and perforation secondary to sporadic, synchronous intra-abdominal DTs in a 54-year old man with atypical symptoms and no risk factors or family history. Discussion Intra-abdominal DTs have a worse prognosis as they can cause intestinal bleeding, obstruction and perforation. Due to the rarity of these tumours there are no clear guidelines on their management and this is instead based on small case series from specialist centres. In the non-acute setting patients with sporadic intra-abdominal DTs should be managed in a specialist sarcoma unit by a multidisciplinary team. In the presence of FAP or other polyposis syndromes patients with DTs should be managed at a specialist colorectal unit. Emergent presentations require emergency surgery in suitable candidates. Conclusion In non-emergency presentations of DTs, it is essential to exclude FAP, AFAP and other hereditary polyposis syndromes since this affects treatment and subsequent follow-up. PMID:26866881

  3. Ogilvie Syndrome and Chilaiditi Syndrome: a Strange Association.

    Bodega Quiroga, I; Tejedor Togores, P; Peraza Casajús, J M; Villadóniga, A; Sánchez-Seco Peña, M I; Serrano Muñoz, A

    2015-12-01

    Chilaiditi syndrome is a strange disease which includes the existence of Chilaiditi sign and other abdominal symptoms. Chilaiditi sign refers the interposition of the colon between the liver and diaphragm that could be misinterpreted to be a pneumoperitoneum. We present a 46-year-old male patient who was admitted in the hospital with constipation and abdominal oppressive pain located in the epigastric area. He showed signs of peritoneal irritation, no bowel sounds, hernias, or organ enlargements. Laboratory analysis only revealed CPK elevation (462 U/L). Abdominal and chest radiographs showed an image which suggested a pneumoperitoneum. The patient underwent emergency surgical treatment, under diagnosis of viscera perforation. At laparotomy, an interposition of the transverse colon between the liver and diaphragm were visualized, although no perforations were present. Psychiatric treatment was held until this moment due to the high risk of schizophrenia outbreak. During the next 48 h, intestinal transit was restored and he was discharged on postoperative day 40, diagnosed with Ogilvie syndrome secondary to psychotropics. The relationship between Ogilvie syndrome and psychiatric treatments is known, but the association between Ogilvie and Chilaiditi syndrome is very strange. Nevertheless, it could be misinterpreted like a pneumoperitoneum and led to the performance of emergency surgery. PMID:26730106

  4. Synovial sarcoma of the abdominal wall

    A case report of synovial sarcoma arising in the abdominal wall is presented. A brief review of the clinical and radiological features of synovial sarcoma is made. Pre-operative diagnosis of an abdominal wall synovial sarcoma is virtually impossible, but should be considered when a soft tissue swelling is found to show amorphous stippled calcification X-ray. (author)

  5. Abdominal Wall Modification for the Difficult Ostomy

    Beck, David E.

    2008-01-01

    A select group of patients with major stomal problems may benefit from operative modification of the abdominal wall. Options may include a modified abdominoplasty (abdominal wall contouring), localized flaps, or liposuction. Although frequently successful, these techniques have the potential for significant morbidity.

  6. Hypoxia inhibits abdominal expiratory nerve activity.

    Fregosi, R F; Knuth, S L; Ward, D K; Bartlett, D

    1987-07-01

    Our purpose was to examine the influence of steady-state changes in chemical stimuli, as well as discrete peripheral chemoreceptor stimulation, on abdominal expiratory motor activity. In decerebrate, paralyzed, vagotomized, and ventilated cats that had bilateral pneumothoraces, we recorded efferent activity from a phrenic nerve and from an abdominal nerve (cranial iliohypogastric nerve, L1). All cats showed phasic expiratory abdominal nerve discharge at normocapnia [end-tidal PCO2 38 +/- 2 Torr], but small doses (2-6 mg/kg) of pentobarbital sodium markedly depressed this activity. Hyperoxic hypercapnia consistently enhanced abdominal expiratory activity and shortened the burst duration. Isocapnic hypoxia caused inhibition of abdominal nerve discharge in 11 of 13 cats. Carotid sinus nerve denervation (3 cats) exacerbated the hypoxic depression of abdominal nerve activity and depressed phrenic motor output. Stimulation of peripheral chemoreceptors with NaCN increased abdominal nerve discharge in 7 of 10 cats, although 2 cats exhibited marked inhibition. Four cats with intact neuraxis, but anesthetized with ketamine, yielded qualitatively similar results. We conclude that when cats are subjected to steady-state chemical stimuli in isolation (no interference from proprioceptive inputs), hypercapnia potentiates, but hypoxia attenuates, abdominal expiratory nerve activity. Mechanisms to explain the selective inhibition of expiratory motor activity by hypoxia are proposed, and physiological implications are discussed. PMID:3624126

  7. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available COMPONENT SEPARATION FOR COMPLEX ABDOMINAL WALL RECONSTRUCTION ALBANY MEDICAL CENTER ALBANY, NY April 30, 2008 00:00:07 ANNOUNCER: This event is being ... the premiere webcast of a component separation for complex abdominal-wall reconstruction, performed by Dr. Jerome D. ...

  8. Actinomycosis mimicking abdominal neoplasm. Case report

    Waaddegaard, P; Dziegiel, M

    1988-01-01

    In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil...

  9. Live secondary abdominal pregnancy- by chance!!

    Akanksha Sood

    2013-04-01

    Full Text Available Abdominal pregnancy though rare but is a life threatening situation, if not recognized and managed properly. We are hereby presenting a rare successful outcome in a case of ruptured live Secondary Abdominal pregnancy with placental implants over intestines. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 251-253

  10. Desmoid tumor in Gardner's Syndrome presented as acute abdomen

    Hatzimarkou, Andreas; Filippou, Dimitrios; Papadopoulos, Vasilios; Filippou, Georgios; Rizos, Spiros; Skandalakis, Panagiotis

    2006-01-01

    Background Gardner's syndrome can occasionally be complicated with intra-abdominal desmoid tumor. These tumors usually remain asymptomatic but can exhibit symptoms due to intestinal, vascular and ureteral compression and obstruction. Case presentation A rare case of a 41-year-old male patient with Gardner's syndrome complicated with intra-abdominal desmoid tumor, which first presented as acute abdomen, is presented. Conclusion Extra-abdominal manifestations of Gardner's syndrome along with a palpable abdominal mass would raise suspicion for the presence of a desmoid tumor in the majority of cases. In life-threatening cases, surgical treatment should be considered as a palliative approach, though the extent of excision remains debatable PMID:16569244

  11. Desmoid tumor in Gardner's Syndrome presented as acute abdomen

    Rizos Spiros

    2006-03-01

    Full Text Available Abstract Background Gardner's syndrome can occasionally be complicated with intra-abdominal desmoid tumor. These tumors usually remain asymptomatic but can exhibit symptoms due to intestinal, vascular and ureteral compression and obstruction. Case presentation A rare case of a 41-year-old male patient with Gardner's syndrome complicated with intra-abdominal desmoid tumor, which first presented as acute abdomen, is presented. Conclusion Extra-abdominal manifestations of Gardner's syndrome along with a palpable abdominal mass would raise suspicion for the presence of a desmoid tumor in the majority of cases. In life-threatening cases, surgical treatment should be considered as a palliative approach, though the extent of excision remains debatable

  12. Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda Factors associated with variation in intracranial pressure in a model of intra-abdominal hypertension with acute lung injury

    Fernando Godinho Zampieri

    2011-06-01

    Full Text Available OBJETIVO: Avaliar o efeito de alterações hemodinâmicas, respiratórias e metabólicas sobre a pressão intracraniana em um modelo de lesão pulmonar aguda e síndrome compartimental abdominal. MÉTODOS: Oito porcos Agroceres foram submetidos, após a instrumentação, a cinco cenários clínicos: 1 estado basal com baixa pressão intra-abdominal e pulmão sadio; 2 pneumoperitôneo, com pressão intra-abdominal de 20 mm Hg; 3 lesão pulmonar aguda induzida por lavagem pulmonar e desativação de surfactante; 4 pneumoperitôneo com pressão intra-abdominal de 20 mm Hg na vigência de lesão pulmonar aguda e com PEEP baixo; e 5 PEEP ajustado a 27 cm H2O na vigência de pneumoperitôneo e lesão pulmonar aguda. Variáveis respiratórias e hemodinâmicas foram coletadas. Análise multivariada foi realizada buscando as variáveis associadas com elevação da pressão intracraniana nos cinco cenários estudados. RESULTADOS: Após a análise multivariada, nas situações não associadas com lesão pulmonar aguda apenas a pressão de platô das vias aéreas se correlacionou positivamente com a pressão intracraniana. Nos modelos associados com lesão pulmonar aguda, a pressão de platô de vias aéreas, a pressão arterial de CO2, o CO2 no final da expiração e a pressão venosa central se correlacionaram positivamente com incrementos da pressão intracraniana. CONCLUSÃO: Em um modelo de disfunção orgânica múltipla com situações clínicas associadas com aumento da pressão torácica e abdominal, o incremento da pressão intracraniana desencadeado pela elevação da pressão abdominal parece ser decorrente da piora da complacência do sistema respiratório e da redução do gradiente para drenagem venosa cerebral ocasionado pela elevação da pressão venosa central.OBJECTIVE: To evaluate the effects of hemodynamic, respiratory and metabolic changes on intracranial pressure in a model of acute lung injury and abdominal compartment syndrome

  13. Fetal abdominal magnetic resonance imaging

    This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages

  14. Fetal abdominal magnetic resonance imaging

    Brugger, Peter C. [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, 1090 Vienna (Austria)]. E-mail: peter.brugger@meduniwien.ac.at; Prayer, Daniela [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria)

    2006-02-15

    This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages.

  15. Prune belly syndrome (sequenze: a case report

    A. Vani

    2013-04-01

    Full Text Available The Prune Belly syndrome (PBS also known as Eagle Barret syndrome is a rare disorder. It is an abdominal muscles deficiency syndrome characterized by a Triad syndrome i.e. deficiency of abdominal wall muscles, failure of testicular descent and dilation of the urinary tract. This syndrome has derived its name from the wrinkled prune appearance of the abdominal wall. Prune Belly syndrome is a rare anomaly seen in one in 35,000-50,000 live births. It occurs in all races. Prune Belly syndrome almost exclusively occurs in males (M:F, 20:1. The diagnosis can be made in utero by ultrasonography at 21 weeks of gestation or in the Neonate with characteristic clinical findings. The present case was a dead male fetus of 20 weeks of gestation sent to Anatomy department after Medical termination of pregnancy, due to congenital anomalies identified in routine ultrasound examination during antenatal checkup. [Int J Res Med Sci 2013; 1(2.000: 148-152

  16. Metabolic syndrome in acute coronary syndrome

    Objective: To determine the frequency of metabolic syndrome in male patients presenting with acute coronary syndrome Study design: A Descriptive study Place and duration of study: Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, from October 2007 to September 2008 Patients and Methods: Male patients with acute coronary syndrome (ACS) were included. Patients having angioplasty (PCI), coronary artery bypass surgery in the past and other co-morbid diseases were excluded. All patients were assessed for the presence of five components of metabolic syndrome including hypertension, HDL-Cholesterol and triglycerides, glucose intolerance and abdominal obesity. Systolic, diastolic blood pressures, waist circumference (WC) and body mass index (BMI) were measured. ECG, cardiac enzymes, fasting glucose and lipid profile were also done. Results: A total of 135 male patients of ACS were studied with a mean age of 54.26 +- 11 years. Metabolic syndrome (MS) was present in 55 (40.7%) patients. MS with all five components was documented in 4 (7.27%) while MS with four and three components was seen in 23 (41.81%) and 28 (50.90%) patients respectively. Only 24 (43.63%) patients with MS had diabetes mellitus, remaining 31(56.36%) were non diabetic. Frequencies of diabetes, hypertension and family history of CAD were significantly higher (p<0.05) in patients with metabolic syndrome as compared to patients with normal metabolic status. Conclusion: Metabolic syndrome is fairly common and important risk factor in patients of IHD. Other risk factors like smoking, dyslipidemia, hypertension and diabetes were also frequently found. Public awareness to control the risk factors can reduce the prevalence of CAD in our country. (author)

  17. Estudo prospectivo de pacientes pediátricos com dor abdominal crônica Prospective study of infants with chronic abdominal pain

    Tatiana Kores Dorsa

    2007-09-01

    were seen in a tertiary pediatric gastroenterology outclinic. Organic diseases were excluded by physical examination and laboratory procedures, and clinical complaints were evaluated according to Rome II criteria for children abdominal pain. In order to establish definitive diagnosis, patients were followed for a mean of three years. RESULTS: Allocation of the 71 patients was: organic disease (n=12, complete remission of symptoms following first clinical presentation (n=7, and functional disease (n=52. Nine patients from the organic disease group, who had been diagnosed as having lactose intolerance, were re-allocated to the functional disease criteria since their symptoms did not relieve when lactose was excluded from their diet. Out of the 52 patients of the functional disease group (median age=9.3 years, 50% boys, nine children with initial diagnosis of functional abdominal pain were re-allocated to functional constipation diagnosis during follow-up, and other 43 patients fulfilled the functional disease diagnosis defined by Rome II: 24 with functional dyspepsia, 18 with functional abdominal pain and one with irritable bowel syndrome. CONCLUSIONS: In a group of children with chronic abdominal pain, functional diseases were found more frequently than organic diseases, and functional dyspepsia was the commonest subtype. Long term follow-up was useful to establish definitive diagnosis in children with chronic abdominal pain.

  18. Effect of exercise training on in vivo insulin-stimulated glucose uptake in intra-abdominal adipose tissue in rats

    Enevoldsen, L H; Stallknecht, B; Fluckey, J D;

    2000-01-01

    Intra-abdominal obesity may be crucial in the pathogenesis of the insulin-resistance syndrome, and training may alleviate this condition. We compared insulin-mediated glucose uptake in vivo in three intra-abdominal adipose tissues (ATs; retroperitoneal, parametrial, and mesenteric) and in...... conclusion, differences between ATs in insulin sensitivity with respect to glucose uptake do not explain that insulin resistance is associated with intra-abdominal rather than subcutaneous obesity. Furthermore, training may be beneficial by enhancing insulin sensitivity in intra-abdominal fat depots.......]glucose and microdialysis techniques. Blood flow was measured by microspheres. Upon insulin stimulation, blood flow generally decreased in AT. Flow was higher in mesenteric tissue than in other ATs, whereas insulin-mediated glucose uptake did not differ between ATs. Training doubled the glucose infusion rate...

  19. Doctor-dependent changes in complaint-related cognitions and anxiety during medical consultations in functional abdominal complaints.

    Dulmen, A.M. van; Fennis, J.F.M.; Mokkink, H.G.A.; Velden, H.G.M. van der; Bleijenberg, G.

    1995-01-01

    This study explored the changes in complaint-related cognitions and anxiety of 110 consecutive out-patients with functional abdominal complaints (irritable bowel syndrome), during a series of consultations. Patients' anxiety, fear of cancer, somatic attribution concerning intestines or stomach and c

  20. Computed tomography of the cervical compartments on the computer tomogram

    The computed tomographic anatomy of the cervical compartsments, with emphasis on the facial planes of the neck, is described. Typical disease processes within these fascial confined compartments have been documented. (orig.)

  1. Condensation within small compartments during design basis accidents

    Grgic, D.; Cavlina, N. [Faculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, 10000 Zagreb (Croatia); ANTOLOVIc, A. [NPP Krsko, Engineering Department, Vrbina 12, 8270 Krsko (Slovenia)

    2010-07-01

    During design basis events (LOCA, MSLB) in containment exists possibility for additional condensation within compartments and enclosures with different electrical equipment that can result in submergence of its parts and possible malfunction. The condensation within limit switch compartments (valve actuators) and attached electrical conduits during limiting LOCA and MSLB accidents in containment was analyzed using Gothic computer code with the assumptions corresponding to the ones used to generate containment EQ profiles for thermalhydraulic EQ parameters. The outcome of the analysis is volume of the liquid within the compartment and corresponding liquid level before and after additions of bottom openings (T-drains) required to drain condensed liquid. Different compartment sizes were analyzed during different LOCA and MSLB scenarios. After addition of bottom openings maximum possible condensed liquid level can not cause actuator malfunction. (authors)

  2. Forests and Forest Cover - Ozark National Forest Service Compartments (polygon)

    NSGIC GIS Inventory (aka Ramona) — Ozark - St. Francis National Forests stand inventory data for vegetation, maintained in polygon format. Compartment is defined as a division of forest for purposes...

  3. Dorfman-Chanarin syndrome

    Gandhi Vijay

    2007-01-01

    Full Text Available A four-year-old girl was brought to the dermatology outpatient department with scaling all over the body since birth. She had history of episodic vomiting and abdominal distension. A dermatological diagnosis of lamellar ichthyosis was made. Abdominal examination revealed a nontender hepatomegaly, fatty liver on ultrasonography and deranged liver function tests. Peripheral blood smear showed lipid vacuoles in the granulocytes consistent with Jordans′ anomaly. Similar lipid vacuoles were seen in the basal layer in skin biopsy. An inflammatory infiltrate, moderate fibrosis in the portal tract and diffuse severe fatty change in hepatocytes were seen in liver biopsy. The patient was diagnosed as a case of Dorfman-Chanarin syndrome.

  4. Two compartment water rod for boiling water reactors

    Matzner, B.; Wolters, B.A.

    1993-07-27

    In a fuel bundle for boiling water nuclear reactor, said fuel bundle is described including a matrix of upstanding fuel rods for undergoing nuclear reaction and generating steam, a lower tie plate for supporting the matrix of fuel rods and admitting liquid water moderator to the fuel bundle from the lower portion of said fuel bundle, an upper tie plate for fastening to at least some of the fuel rods and permitting the outflow of liquid and vapor water moderator from the upper portion of said fuel bundle, a channel surrounding said upper and lower tie plates and said fuel rods therebetween for confining moderator flow between said tie plates and around said fuel rods, and a plurality of vertically spaced apart fuel rod spacers, each said spacer surrounding each said fuel rod at the particular elevation of said spacer for maintaining said fuel rods in side-by-side relation, and a water rod for installation to said fuel bundle for supplying liquid moderator to the upper two phase region of said fuel bundle, the improvement to said water rod comprising: said water rod having a first upper compartment, and a second lower compartment, said upper compartment isolated from said lower compartment; said first upper compartment defining an open, upwardly exposed end for receiving and maintaining water in said upper water rod compartment during the power generating operation of said fuel bundle will fill with liquid by gravity flow from above; means communicated to the bottom portion of said lower compartment for receiving water from said lower portion of said fuel bundle; and, means communicated to the upper portion of said lower compartment for discharging water to the interior of said fuel bundle below the upper most spacer of said fuel bundle whereby discharge to said fuel bundle occurs in said upper two phase region of said bundle.

  5. Medial compartment disease in a young Large Munsterlander

    Coppieters, Eva; Samoy, Yves; Pey, Pascaline; Waelbers, Tim; Van Ryssen, Bernadette

    2012-01-01

    Medial compartment disease (MCD) is a recently recognized elbow disorder in dogs and refers to extensive cartilage erosions of the medial compartment of the elbow joint. This report describes a case of MCD in a 10-month-old Large Munsterlander that was presented with right frontleg lameness. Based on signalement, history and radiographic examination, there was a strong suspicion of a fragmented coronoid process (FCP) of the right elbow. However, arthroscopic examination revealed extensive car...

  6. Two compartment water rod for boiling water reactors

    In a fuel bundle for boiling water nuclear reactor, said fuel bundle is described including a matrix of upstanding fuel rods for undergoing nuclear reaction and generating steam, a lower tie plate for supporting the matrix of fuel rods and admitting liquid water moderator to the fuel bundle from the lower portion of said fuel bundle, an upper tie plate for fastening to at least some of the fuel rods and permitting the outflow of liquid and vapor water moderator from the upper portion of said fuel bundle, a channel surrounding said upper and lower tie plates and said fuel rods therebetween for confining moderator flow between said tie plates and around said fuel rods, and a plurality of vertically spaced apart fuel rod spacers, each said spacer surrounding each said fuel rod at the particular elevation of said spacer for maintaining said fuel rods in side-by-side relation, and a water rod for installation to said fuel bundle for supplying liquid moderator to the upper two phase region of said fuel bundle, the improvement to said water rod comprising: said water rod having a first upper compartment, and a second lower compartment, said upper compartment isolated from said lower compartment; said first upper compartment defining an open, upwardly exposed end for receiving and maintaining water in said upper water rod compartment during the power generating operation of said fuel bundle will fill with liquid by gravity flow from above; means communicated to the bottom portion of said lower compartment for receiving water from said lower portion of said fuel bundle; and, means communicated to the upper portion of said lower compartment for discharging water to the interior of said fuel bundle below the upper most spacer of said fuel bundle whereby discharge to said fuel bundle occurs in said upper two phase region of said bundle

  7. Coexistence of congenital diaphragmatic hernia and abdominal wall closure defect with chromosomal abnormality: two case reports

    INOUE, SEIICHIRO; ODAKA, AKIO; Muta, Yuki; Beck, Yoshifumi; Sobajima, Hisanori; Tamura, Masanori

    2016-01-01

    Background We reported two rare cases of congenital diaphragmatic hernia with abdominal wall closure defect, which were not associated with septum transversum diaphragmatic defects or Fryns syndrome. Case presentation Case 1: a Japanese baby boy was delivered at 37 weeks’ gestation by urgent cesarean section because of the diagnosis of severe fetal distress. Congenital diaphragmatic hernia with omphalocele was prenatally diagnosed with fetal ultrasound. A ruptured omphalocele was confirmed at...

  8. Gastrointestinal and renal abnormalities in cardio-facio-cutaneous syndrome

    Cardio-facio-cutaneous syndrome (CFC) is an uncommon autosomal recessive condition recently distinguished from Noonan syndrome but with more marked growth failure and ectodermal dysplasia. Abdominal symptoms are frequently described but anatomic lesions in CFC have rarely been described. We have found significant anatomic abnormalities in CFC patients including antral foveolar hyperplasia, severe constipation with fecal impaction, nephrocalcinosis and renal cysts. (orig.)

  9. Fatal splenic rupture in Ehlers-Danlos syndrome.

    Harris, S. C.; Slater, D N; Austin, C. A.

    1985-01-01

    A fatal case of Ehlers-Danlos syndrome (Type IV) is described. Autopsy revealed splenic rupture that had resulted from spontaneous haemorrhage into the splenic parenchyma. This is a previously unrecorded complication of Ehlers-Danlos syndrome and should be considered in the differential diagnosis of chest and abdominal pain in patients with this condition.

  10. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Ghodratollah Maddah

    2014-05-01

    Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

  11. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Maddah, Ghodratollah; Shabahang, Hossein; Abdollahi, Abbas; Zehi, Vahid; Abdollahi, Mohsen

    2014-01-01

    The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag). The study population comprised of 11 (57.9%) male and 8 (42.1%) female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9%) patients, subjective judgment that the fascia closure is too tight in 6 (31.6%) patient's damage control surgery in one patient (5.3%) and development of abdominal compartment surgery in one patient (5.3%). Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4%) patients, post operative intestinal fistula in 4 (21.1%) patients, post traumatic intra abdominal bleeding in 3 (15.8%) patients and intestinal obstructions in 3 (15.8%) patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0%) patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1) early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3%) late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54) months. Currently 10 patients (52.6%) are alive at a follow up of 45 (range 1

  12. Microbial investigations of deep geological compartments

    Document available in extended abstract form only. Deep sedimentary rocks are now considered to contain a significant part of the total bacterial population, but are microbiologically unexplored. The drilling down to the base of the Triassic (1980 meters deep) in the geological formations of the eastern Paris Basin performed by ANDRA (EST433) in 2008 provides us a good opportunity to explore the deep biosphere. We conditioned and sub-sampled on the coring site, in as aseptic conditions as possible, the nine cores: two in the Callovo-Oxfordian clay, two in the Dogger, five in the Triassic compartments. In addition to storage at atmospheric pressure, a portion of the five Triassic samples was placed in a 190 bars pressurized bars chamber to investigate the influence of the conservation pressure factor on the found microflora. In parallel, in order to evaluate a potential bacterial contamination of the core by the drilling fluids, samples of mud just before each sample drilling were taken and analysed. The microbial exploration we started can be divided in two parts: - A cultural approach in different culture media for six metabolic groups to try to find microbial cells still viable. This type of experiment is difficult because of the small proportion of cultivable species, especially in these extreme environmental samples. - A molecular approach by direct extraction of genomic DNA from the geological samples to explore a larger biodiversity. Here, the limits are the difficulties to extract DNA from these low biomass containing rocks. The five Triassic samples were partly crushed in powder and inoculated in the six culture media with four NaCl concentrations, because this type of rock is known as saline or hyper-saline, and incubated at three temperatures: 30 deg. C, 55 deg. C under agitation and 70 deg. C. First results will be presented. The direct extraction of DNA needs a complete method optimisation to adapt existent procedures (using commercial kit and classical

  13. Extra pontine osmotic demyelination syndrome

    Zunga, Pervaiz M.; Farooq, Omar; Dar, Mohd I.; Dar, Ishrat H; Rashid, Samia; Rather, Abdul Q.; Basu, Javid A; Ashraf, Mohammed; Jahangeer A. Bhat

    2015-01-01

    The osmotic demyelination syndrome (ODS) has been identified as a complication of the rapid correction of hyponatremia for decades. However, in recent years, a variety of other medical conditions have been associated with the development of ODS, independent of changes in serum sodium which cause a rapid changes in osmolality of the interstitial (extracellular) compartment of the brain leading to dehydration of energy-depleted cells with subsequent axonal damage that occurs in characteristic a...

  14. Rapunzel syndrome: a rare postpartum case.

    Tegene, Teshome; Foda, Yahia; Hussain, Omar; Oloniyo, Kolawole; Ha, Ngoc-Tram; Manikonda, Geeta

    2013-01-01

    The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman. PMID:24171124

  15. Rapunzel Syndrome: A Rare Postpartum Case

    Teshome Tegene

    2013-01-01

    Full Text Available The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman.

  16. Abdominal Burkitt lymphoma in children : CT finding

    To evaluate the CT findings of Burkitt's lymphoma involving the abdomen in children We retrospectively analyzed the abdominal CT of ten children who presented with abdominal symptom. They were confirmed by operation in two cases and by fine needle aspiration biopsy in eight to be suffering from Burkitt's lymphoma. We also abdominal ultrasonography(USG)(n=10) and carried out small bowel follow-through examination(SBS)(n=5). Analyses focused on features of the abdominal mass : bowel wall thickening, ascites, lymphadenopathy, and the involvement of intra-abdominal solid organ. Abdominal CT at the time of presentation showed a huge conglomerated mass encasing segments of small bowel and also peripherally displacing bowel loops(n=9), bowel wall thickening(n=10), and ascites(n=10). In three of these cases, we were able to see tumor necrosis and cavity formation. Extensive infiltration into mesenteric fat and obliteration of tissue plane made it impossible to identify on CT the margin of the tumor and the presence of mesenteric lymphadenopathy. In four patients, sonography showed enlarged mesenteric lymph nodes(15-20mm), and in three, retroperitoneal lymph nodes(5mm, 10mm, 12mm in long dimension) were detected on CT and USG. Abdominal CT can reveal the characteristic imaging features of Burkitt's lymphoma in children. These are a huge conglomerate mass with or without cavity formation, that encases the small bowel and infiltrates the mesentery, ascites, and the relatively spared retroperitoneal lymph nodes

  17. Abdominal Burkitt lymphoma in children : CT finding

    Song, Jae Uoo; Kim, Woo Sun; Kim, In One; Yeon, Kyung Mo; Ahn, Hyo Seop; Shin, Hee Young [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Song, Chi Sung [Seoul City Boramae Hospital Department of Radiology, Seoul (Korea, Republic of)

    1996-10-01

    To evaluate the CT findings of Burkitt's lymphoma involving the abdomen in children We retrospectively analyzed the abdominal CT of ten children who presented with abdominal symptom. They were confirmed by operation in two cases and by fine needle aspiration biopsy in eight to be suffering from Burkitt's lymphoma. We also abdominal ultrasonography(USG)(n=10) and carried out small bowel follow-through examination(SBS)(n=5). Analyses focused on features of the abdominal mass : bowel wall thickening, ascites, lymphadenopathy, and the involvement of intra-abdominal solid organ. Abdominal CT at the time of presentation showed a huge conglomerated mass encasing segments of small bowel and also peripherally displacing bowel loops(n=9), bowel wall thickening(n=10), and ascites(n=10). In three of these cases, we were able to see tumor necrosis and cavity formation. Extensive infiltration into mesenteric fat and obliteration of tissue plane made it impossible to identify on CT the margin of the tumor and the presence of mesenteric lymphadenopathy. In four patients, sonography showed enlarged mesenteric lymph nodes(15-20mm), and in three, retroperitoneal lymph nodes(5mm, 10mm, 12mm in long dimension) were detected on CT and USG. Abdominal CT can reveal the characteristic imaging features of Burkitt's lymphoma in children. These are a huge conglomerate mass with or without cavity formation, that encases the small bowel and infiltrates the mesentery, ascites, and the relatively spared retroperitoneal lymph nodes.

  18. Abdominal ultrasonographic findings of Yersiniosis in children

    To review abdominal ultrasonography in Yersinia Pseudotuberculosis(YP) infection. From June 1993 through June 1994, abdominal ultrasonograms were reviewed in 36 patients with YP infection. The age of patients was from 4 to 14 years. A diagnosis of YP infection was made on the basis of isolation of YP from stool (n=15/36, 41.7%) and by documenting at least a minimum agglutination antibody titer of 1;160 or greater (n=34/36, 94.4%). Abdominal US findings were identified in 33/36 (91.7%) of patients with YP infection. US abnormalities included right lower quadrant abdominal lymphadenopathy in 28/36 (77.8%) of cases: increased bilateral renal cortical echogenecity with renal enlargement, 11/36 (30.6%) of cases:hepatosplenomegaly, 6/36 (16.7%) of cases: bowel wall thickening in termnal ileum and cecum, 4/36 (11.1%) of cases:and ascites, 2/36 (5.5%) of cases. Three patients revealed no abdominal sonographic finding. We conclude that abdominal US can help in the diagnosis of YP infection when US demonstrates multiple right lower quadrant abdominal lymphadenopathy, increased renal cortical echogenecity with renal enlargement, hepatosplenomegaly, intestinal wall thickening or ascites

  19. Radiologic findings of abdominal wall endometriosis

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer

  20. Radiologic findings of abdominal wall endometriosis

    Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2003-12-01

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.

  1. A Rare Cause of Macroscobic Hematuria: Nutcracker Syndrome

    Nilgün Selçuk Duru

    2015-03-01

    Full Text Available Nutcracker syndrome caused by compression of the left renal vein between the abdominal aorta and the superior mesenteric artery is a rare anatomo-pathological condition. The patients have symptoms such as hematuria, proteinuria, and left flank pain. In this paper, we report a 13-year-old boy who presented with macroscopic haematuria. Routine laboratory tests for the evaluation of hematuria were normal. Abdominal computed tomography revealed that the left renal vein was compressed between the aorta and the superior mesenteric artery. A diagnosis of nutcracker syndrome was established. If Nutcracker syndrome is considered in the differential diagnosis of haematuria, it is easily diagnosed by imaging techniques.

  2. Non-compartment model to compartment model pharmacokinetics transformation meta-analysis – a multivariate nonlinear mixed model

    2010-01-01

    Background To fulfill the model based drug development, the very first step is usually a model establishment from published literatures. Pharmacokinetics model is the central piece of model based drug development. This paper proposed an important approach to transform published non-compartment model pharmacokinetics (PK) parameters into compartment model PK parameters. This meta-analysis was performed with a multivariate nonlinear mixed model. A conditional first-order linearization approach ...

  3. Combined subcutaneous, intrathoracic and abdominal splenosis.

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue. PMID:20804314

  4. Roentgenologic evaluation of blunt abdominal trauma

    This study comprises 25 cases of blunt abdominal trauma proved by surgery. It is concluded that visceral damage by blunt abdominal trauma may be suspected, but can not be satisfactorily diagnosed upon a single plane abdominal roentgenologic examination with clinical support. Contrary to some reports in the literature, rupture of the hallow, viscus is more susceptible than solid organ and ileum is more than jejunum. It is a useful roentgenologic sign denoting distension and small cresent air shadow in the duodenal sweep of the damaged pancreas

  5. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  6. [Abdominal spasms, meteorism, diarrhea: fructose intolerance, lactose intolerance or IBS?].

    Litschauer-Poursadrollah, Margaritha; El-Sayad, Sabine; Wantke, Felix; Fellinger, Christina; Jarisch, Reinhart

    2012-12-01

    Meteorism, abdominal spasms, diarrhea, casually obstipation, flatulence and nausea are symptoms of fructose malabsorption (FIT) and/or lactose intolerance (LIT), but are also symptoms of irritable bowel syndrome (IBS). Therefore these diseases should be considered primarily in patients with digestive complaints. For diagnosis an H(2)-breath test is used.In 1,935 patients (526 m, 1,409 f) a fructose intolerance test and in 1,739 patients (518 m,1,221 f) a lactose intolerance test was done.FIT is found more frequently than LIT (57 versus 52 % in adults (p fructose or lactose may lead to improvement or remission of these metabolic disorders. IBS, which is often correlated with FIT (183/221 patients = 83 %), can be improved by relevant but also not relevant diets indicating that irritable bowel disease seems to be caused primarily by psychological disorders. PMID:23224632

  7. Antiphospholipid Syndrome

    ... Awards Enhancing Diversity Find People About NINDS NINDS Antiphospholipid Syndrome Information Page Synonym(s): Hughes Syndrome Table of Contents ( ... research is being done? Clinical Trials What is Antiphospholipid Syndrome? Antiphospholipid syndrome (APS) is an autoimmune disorder caused ...

  8. Staging of pediatric abdominal malignancies

    The scope of this review is the role of CT in the staging of childhood solid abdominal malignancies. Owing to the limitations of space, only the commonest lesions will be discussed in detail: Wilms' tumor, neuroblastoma, and liver tumors. The TNM staging system has been utilized throughout this monograph. It will not be used in this chapter, however, since in this country different staging systems individualized to each pediatric tumor have been developed. These staging systems take into account the different biology of each tumor and have clear correlations with prognosis and therapeutic programs. The discussion centers almost exclusively on the role of CT in the staging and management of neoplastic processes in children. The information required for staging can sometimes be obtained by other imaging modalities (i.e., ultrasound, excretory urography, etc.) The choice of modality will be strongly influenced by techniques and expertise available as well as by the bias of the institution. An additional factor to be taken into consideration will be the economic factor. Prospective reimbursement will strongly encourage the use of tests that are cost-effective and clinically efficacious

  9. Variations in abductor pollicis longus and extensor pollicis brevis tendons in the Quervain syndrome: a surgical and anatomical study.

    Kulthanan, Teerawat; Chareonwat, Boonsong

    2007-01-01

    Eighty-two wrists of Thai cadavers and the wrists of 66 patients with de Quervain syndrome were studied, and the variation in the number of tendons and the fibro-osseous tunnel in the first extensor compartment were recorded. The abductor pollicis longus had more than one tendon in 73 of the cadavers (89%) and in 32 of the patients (49%) (p de Quervain syndrome (p = 0.01). The results indicate that the number of fibro-osseous tunnels and multiple compartments in the first extensor compartment may be associated with a predisposition to de Quervain syndrome. PMID:17484184

  10. Hepatic computed tomography perfusion. Comparison of maximum slope and dual-input single-compartment methods

    The aim of the study was to compare two analytical methods-maximum slope (MS) and the dualinput single-compartment model (CM)-in computed tomography (CT) measurements of hepatic perfusion and to assess the effects of extrahepatic systemic factors. A total of 109 patients underwent hepatic CT perfusion. The scans were conducted at the hepatic hilum 7-77 s after administration of contrast material. Hepatic arterial perfusion (HAP) and portal perfusion (HPP) (ml/min/100 ml) and the arterial perfusion fraction (APF, %) were calculated with the two methods, followed by correlation assessment. Partial correlation analysis was used to assess the effects on hepatic perfusion values by various factors, including age, sex, risk of cardiovascular disease, compensation for respiratory misregistration, arrival time of contrast material at the abdominal aorta, transit time from abdominal aorta to hepatic parenchyma, and liver dysfunction. The mean HAPs, HPPs, and APFs were, respectively, 31.4, 104.2, and 23.9 for MS and 27.1, 141.3, and 22.1 for CM. HAP and APF showed significant (P<0.0001) and moderate correlation (γ=0.417 and 0.548) and HPP showed poor correlation (γ=0.172) between the two methods. While MS showed weak correlations (γ=-0.39 to 0.34; P<0.001 to <0.02) between multiple extrahepatic factors and perfusion values, CM showed weak correlation only between the patients' sex and HAP (γ=0.31, P=0.001). Hepatic perfusion values estimated by the two methods are not interchangeable. CM is less susceptible to extrahepatic systemic factors. (author)

  11. SIRENOMELIA: MERMAID SYNDROME

    Sharmila Pal

    2014-11-01

    Full Text Available A neonate with rare congenital anomalies was born at 25 weeks of gestation and died within 17 minutes of birth. On examination of the baby, it was found that the lower limbs were malrotated and fused all along the length with six toes. External genitalia, urogenital and anal orifices were absent. At autopsy, a single umbilical artery was found arising from the abdominal aorta. Both the kidneys were polycystic and were situated in the iliac fossae. Distal portion of the large gut beyond caecum was absent and rectum was atretic. No reproductive organ was found. On the basis of the findings, the case was diagnosed as sirenomelia (mermaid syndrome.

  12. Caudal duplication syndrome.

    Ramzan, Muhammad; Ahmed, Shoaib; Ali, Salman

    2014-01-01

    Complete duplication of genitourinary system, colon and vertebral column is a very rare and complex congenital condition termed as "caudal duplication syndrome" with variable presentations. This term is often quoted as a type of incomplete separation of mono-ovular twins or conjoined twinning. It is associated with other congenital malformations of the genitourinary, gastrointestinal and other organ systems. The hereby reported case, a 3-month-old male infant had presented with the classical form of the disease i.e., duplication of the gastrointestinal, genitourinary system and vertebral column with anterior abdominal wall hernia and a large lipomeningocele. PMID:24411548

  13. Caudal Duplication Syndrome

    Complete duplication of genitourinary system, colon and vertebral column is a very rare and complex congenital condition termed as caudal duplication syndrome with variable presentations. This term is often quoted as a type of incomplete separation of mono-ovular twins or conjoined twinning. It is associated with other congenital malformations of the genitourinary, gastrointestinal and other organ systems. The hereby reported case, a 3-month-old male infant had presented with the classical form of the disease i.e., duplication of the gastrointestinal, genitourinary system and vertebral column with anterior abdominal wall hernia and a large lipomeningocele. (author)

  14. Bilateral accessory flexor digitorum muscle in the posterior compartment of the leg

    Singh R

    2010-10-01

    Full Text Available Deep muscles of the posterior compartment of the leg constitute of the flexor hallucis longus, flexor digitorum and tibialis posterior. During the routine dissection of a 53-year-old male cadaver of Indian origin, an accessory muscle was observed in the posterior compartment of the both the legs, deep to the soleus muscle. The muscle originated as a slender tendon from the medial border of the tibia, led to a small belly of the muscle fibers arranged bipinnately and converged into another slender tendon. The tendon got inserted at the second toe in the left foot, after joining both the slip of the flexor hallucis longus and the flexor digitorum longus muscle tendon in the sole. In the right leg, the accessory muscle tendon was inserted to the calcaneus with fibrous attachments to the quadratus plantae, flexor hallucis longus and the flexor digitorum longus. The present case will facilitate in interpretation of the medial side swelling of the leg, tarsal tunnel syndrome or pain due to muscle entrapment, by the radiologists surgeons and orthopedists.

  15. Obstructed labour caused by rare congenital anomaly of foetus: managed by foetal abdominal tapping leading to successful vaginal delivery

    Neelam Swaroop

    2015-08-01

    Full Text Available Obstructed labour with high maternal morbidity and mortality is still prevalent in the developing world. The common causes of obstructed labour include contracted pelvis, uterine abnormalities, maternal pelvic tumours, foetal malpresentation, and congenital foetal abnormalities like hydrocephalus, polycystic kidneys/hydronephrosis or locked twins. Here we present a case of rare congenital anomaly of foetus, Prune belly syndrome causing obstructed labour in its course and managed by foetal abdominal tapping leading to successful vaginal delivery. Prune belly syndrome is a rare congenital disease characterized by abdominal wall muscle abnormalities, urinary tract abnormalities and cryptorchidism. It is also associated with cardiovascular, genital, respiratory and other musculoskeletal malformations. Since this patient had no antenatal visit the syndrome was diagnosed after detailed examination of still born foetus. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1220-1222

  16. The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 2: measurement techniques and management recommendations.

    Malbrain, Manu L N G; De Laet, Inneke; De Waele, Jan J; Sugrue, Michael; Schachtrupp, Alexander; Duchesne, Juan; Van Ramshorst, Gabrielle; De Keulenaer, Bart; Kirkpatrick, Andrew W; Ahmadi-Noorbakhsh, Siavash; Mulier, Jan; Pelosi, Paolo; Ivatury, Rao; Pracca, Francisco; David, Marcelo; Roberts, Derek J

    2014-01-01

    The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (Cab) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low Cab. However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and Cab and how certain conditions may affect the results. This review will give a concise overview of the different methods to assess and estimate Cab; it will list important conditions that may affect baseline values and suggest some therapeutic options. Abdominal compliance (Cab), defined as a measure of the ease of abdominal expansion, is measured differently than IAP. The compliance of the abdominal wall is only a part of the total abdominal pressure-volume (PV) relationship. Measurement or estimation of Cab is difficult at the bedside and can only be done in a case of change (removal or addition) in IAV. The different measurement techniques will be discussed in relation to decreases (ascites drainage, haematoma evacuation, gastric suctioning) or increases in IAV (gastric insufflation, laparoscopy with CO₂ pneumoperitoneum, peritoneal dialysis). More specific techniques using the interactions between the thoracic and abdominal compartment during positive pressure ventilation will also be discussed (low flow PV loop, respiratory IAP variations, respiratory abdominal variation test, mean IAP and abdominal pressure variation), together with the concept of the polycompartment model. The relation between IAV and IAP is linear at low IAV and becomes curvilinear and exponential at higher volumes. Specific conditions in relation to increased (previous pregnancy or laparoscopy, gynoid fat distribution, ellipse-shaped internal abdominal perimeter) or decreased Cab (obesity, fluid overload, android fat distribution, sphere-shaped internal abdominal perimeter) will be discussed

  17. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available ... was yes, it did -- right here -- it did cause seromas as well. Another thing was that the ... is two things: one is it's going to cause more adherence of the Veritas to the abdominal ...

  18. An Unusual Case of Abdominal Pain

    Bobby Desai

    2012-01-01

    Full Text Available Renal calyceal rupture is a usual etiology of abdominal pain in the emergency department. We present a case of unexpected renal calyx rupture in a patient with symptomatology of renal colic. A discussion and review are provided.

  19. Asthma May Raise Risk for Abdominal Aneurysm

    ... nlm.nih.gov/medlineplus/news/fullstory_157202.html Asthma May Raise Risk for Abdominal Aneurysm Airway disease ... People 50 and older who have had recent asthma activity appear to be at an increased risk ...

  20. Adhesive intestinal obstruction following blunt abdominal trauma

    Advances in diagnosis and management of multiple trauma patients have lead to adopting a conservative approach for most patients with blunt abdominal trauma. Intestinal obstruction is a rare complication for this approach. Herein, we report a 37-year-old male, who did not have an abdominal operation, and who developed adhesive intestinal obstruction 7 weeks following blunt abdominal trauma. We detected no signs of peritonitis or intra-abdominal bleeding clinically or radiologically on admission. We initially treated the intestinal obstruction conservatively, but the obstruction did not resolve. Finally, we performed laparotomy, which showed that the small bowel was matted together by thick fibrous layers of adhesions. We performed adhesiolysis, and the patient was discharged home 3 weeks later. Histopathological findings of the fibrous layer were consistent with repair due to previous trauma and hemorrhage. We review the literature of this rare condition. (author)

  1. Rotura e Hematoma do Recto Abdominal

    Moura, D.; Lindo, T

    2013-01-01

    A miologia ântero-lateral do abdómen é constituída por dois músculos longos, o recto abdominal e o piramidal e três músculos largos, o oblíquo externo, oblíquo interno e transverso abdominal. A bainha do recto abdominal é formada pelas aponevroses de inserção anteriores dos músculos largos do abdómen em volta do recto abdominal, tendo camada anterior e camada posterior. Estes músculos abdominais são responsáveis por flexão e rotação do tronco, compressão e suporte/estabilidade de vísceras abd...

  2. Component Separation for Complex Abdominal Wall Reconstruction

    Full Text Available COMPONENT SEPARATION FOR COMPLEX ABDOMINAL WALL RECONSTRUCTION ALBANY MEDICAL CENTER ALBANY, NY April 30, 2008 00:00: ... Koumanis. The surgery comes to you from Albany Medical Center in Albany, New York. In just moments, ...

  3. Genetics Home Reference: abdominal wall defect

    ... size and can usually be diagnosed early in fetal development, typically between the tenth and fourteenth weeks of ... organs at the abdominal wall opening late in fetal development may also contribute to organ injury. Intestinal damage ...

  4. Surveillance intervals for small abdominal aortic aneurysms

    Bown, Matthew J; Sweeting, Michael J; Brown, Louise C;

    2013-01-01

    Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture....

  5. Audit of abdominal pain in general practice

    Edwards, M.W.; Forman, W.M.; Walton, J.

    1985-01-01

    An audit of 150 consecutive cases of abdominal pain presenting to an urban teaching practice between October 1983 and May 1984 was performed. The median duration of pain prior to presentation was two days. Females predominated in all age groups.

  6. Using abdominal massage in bowel management.

    Connor, Michelle; Hunt, Catherine; Lindley, Alison; Adams, John

    2014-07-15

    This article describes the introduction of abdominal massage techniques by a community team as part of a total bowel management programme for people with learning disabilities. A trust-wide audit of prescribed laxative use by this client group raised concerns, and led to a more systematic approach to managing constipation in people with learning disabilities. An education programme for carers proved to be successful. Some reported that adopting abdominal massage provided further opportunity to develop the therapeutic relationship. PMID:25005415

  7. Factors associated with abdominal obesity in children

    Matheus Ribeiro Theodósio Fernandes Melzer; Isabella Mastrangi Magrini; Semíramis Martins Álvares Domene; Paula Andrea Martins

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's wa...

  8. Traumatic pseudoaneurysm of the abdominal aorta.

    Barchiche, R; Bové, T; Demanet, H; Goldstein, J P; Deuvaert, F E

    1999-08-01

    A traumatic pseudoaneurysm of the abdominal aorta is a rare entity, occurring as the result of a missed aortic lesion at the time of the initial injury. Therefore, clinical suspicion and careful abdominal exploration at first laparotomy is mandatory to prevent aortic pseudoaneurysm formation and its risk of delayed rupture. We present a case of successful surgical treatment of a suprarenal aortic false aneurysm, presenting 4 weeks after a life-threatening gunshot wound in a 13-year-old child. PMID:10499389

  9. A rare nonincisional lateral abdominal wall hernia

    Kim, Dong-Ju; Park, Jin-Woo

    2015-01-01

    A 68-year-old woman presented a rare lateral abdominal wall hernia. Three month before admission to Chungbuk National University Hospital, she found a large protruding mass measuring 8 cm in diameter in the midaxillary line just below the costal margin upon heavy coughing. She had no history of abdominal trauma, infection, or operation previously. The mass was easily reduced manually or by position change to left lateral decubitus. CT scan showed a defect of the right transversus abdominis mu...

  10. Abdominal integument atrophy after operative procedures

    Smereczyński, Andrzej; Kołaczyk, Katarzyna; Lubiński, Jan; Bojko, Stefania; Gałdyńska, Maria; Bernatowicz, Elżbieta

    2012-01-01

    The aim of the study was to analyze clinical material concerning postoperative atrophy of abdominal integument. Material and methods The evaluated group consisted of 29 patients with sonographically revealed atrophy of the abdominal wall. Those changes were observed after various surgical procedures: mainly after long, anterolateral laparotomies or several classical operations. Ultrasound examinations up to the year 2000 were performed with analog apparatus, in the latter years only with digi...

  11. Anesthetic Considerations for Abdominal Wall Reconstructive Surgery

    Slabach, Rachel; Suyderhoud, Johan P.

    2012-01-01

    Anesthesia considerations for abdominal wall reconstruction (AWR) are numerous and depend upon the medical status of the patient and the projected procedure. Obesity, sleep apnea, hypertension, and cardiovascular disease are not uncommon in patients with abdominal wall defects; pulmonary functions and cardiac output can be affected by the surgical procedure. Patients with chronic obstructive pulmonary disease are also at a higher risk of coughing during the postoperative awakening process, wh...

  12. Asymptomatic torsion of intra-abdominal testis

    M. Amin El-Gohary

    2015-01-01

    We report a case of intra-abdominal testicular torsion, of eight years old boy who presented with asymptomatic left impalpable testis. Diagnostic laparoscopy revealed a twisted small intra-abdominal testis in which the spermatic cord twisted 3 times over a band attached to the internal ring. The cord was long enough to bring the small testis into the scrotal sac. This case highlights the pole of laparoscopy in the management of impalpable testes.

  13. Ogilvie’s Syndrome following Cardioversion for Atrial Fibrillation

    Moh’d Al-Halawani; Juanito Savaille; Mohammad Thawabi; Yazan Abdeen; Miller, Richard A; Fedida, Andre A.

    2014-01-01

    Acute colonic pseudoobstruction, also known as Ogilvie's syndrome, is characterized by distension of the colon in the absence of a mechanical obstruction as evident by abdominal radiography. This syndrome is usually treated conservatively; however, medical or surgical therapies can be employed in refractory cases. Ogilvie's syndrome has been reported following cardiac events, such as myocardial infarction, heart failure, and cardiac bypass surgeries. We report the first case of Ogilvie's synd...

  14. Rapunzel Syndrome: A Rare Presentation with Giant Gastric Ulcer

    Antonios Athanasiou

    2014-01-01

    Full Text Available The Rapunzel syndrome refers to an uncommon and rare form of trichobezoar that extends past the stomach into the small intestines. The Rapunzel syndrome is usually found in young female patients with a history of psychiatric disorders, mainly trichotillomania and trichophagia. We describe a case of Rapunzel syndrome in a 15-year-old girl who presented with abdominal pain, vomiting, and weight loss. We performed a surgical laparotomy and successfully removed a huge trichobezoar extending into the small intestine.

  15. Effect of arthritis in other compartment after unicompartmental arthroplasty.

    Mofidi, Ali; Lu, Bo; Plate, Johannes F; Lang, Jason E; Poehling, Gary G; Jinnah, Riyaz H

    2014-07-01

    The purpose of this study is to evaluate the outcome of robotic-assisted (MAKO Surgical Corp.) unicondylar replacement in the treatment for knee osteoarthritis after the initial surgical insult is worn off to evaluate the impact of residual patellofemoral and lateral osteoarthritis on the outcome of medial unicompartmental knee replacement. One hundred and thirty-four patients who underwent uncomplicated 144 robotic-assisted medial unicondylar replacements for knee arthritis were identified and studied. Original radiographs were used to classify severity of patellofemoral and lateral compartmental osteoarthritis in these patients. Severity of patellofemoral and lateral compartmental osteoarthritis was analyzed against Oxford and Knee Society scores and amount of ipsilateral residual knee symptoms at 6 months postoperative period. Preoperative Oxford and Knee Society scores, other comorbidities and long-term disability were studied as confounding variables. We found significant improvement in symptoms and scores in spite of other compartment diseases. Poorer outcome was seen in association with comorbidities and long-term disability but not when radiographic signs of arthritis in the other compartments were present. Six patients required revision of which three had (lateral facet) patellofemoral disease in the original X-rays. In conclusion, there is a higher amount of postoperative retained symptoms, but similar outcome when there is radiographic disease in the other compartments. However, when symptoms are severe enough to necessitate revision, this is due to the lateral facet of patellofemoral compartment and not lateral compartment disease. PMID:23771595

  16. Diagnosis and treatment of expanding haematoma of the lateral abdominal wall after blunt abdominal trauma

    We report a rare case of an expanding post-traumatic lateral abdominal wall haematoma. A superselective arteriogram of the deep circumflex iliac artery showed extravasation from the ascending branch, urging emergency therapy. Microcoil and Gelfoam embolisation was successfully performed. Haematomas of the abdominal wall can be divided in the common rectus sheath haematomas and the rare haematomas of the lateral abdominal wall. Differentiating both entities is essential, since there is a strong difference in their vascular supply. The typical vascular supply of the lateral abdominal wall is discussed, with emphasis on the ascending branch of the deep circumflex iliac artery. (orig.)

  17. Metabolic complications in the small intestine syndrome

    Metabolic complications in the syndrome of small intestine is presented in a patient of masculine sex, 27 years old, who consulted for a square of inflammation gingival, migraine, fever, anorexia and adinamia for three days, followed by maculopapular-eritematose eruption for 8 days, coincident with the ampicillin ingestion, and later on severe abdominal pain and diarrhea

  18. Abdominal tuberculosis: clinical presentation and outcome

    To study the clinical presentation and outcome of cases of Abdominal Tuberculosis. Fifty four patients of Abdominal Tuberculosis were seen during the study period. Four patients were lost to follow-up, which were excluded. Detailed information of all the patients including age, sex, symptoms, signs, investigations and management was recorded, analyzed and compared with local and international data. Out of the 50 patients with Abdominal Tuberculosis, 31 were females and 19 males. Their ages ranged from 17 to 63 years, with a mean age of 25.1 years. Thirty five cases were admitted through Emergency and 15 through Outpatients departments. Abdominal pain was the most common symptom found in 44 (88%) patients followed by vomiting in 33 (66%). Abdominal tenderness was seen in 22 (44%) patients, while 16 (32%) patients had rigidity and other features of peritonitis. Surgery was performed in all these patients, limited right hemicolectomy in 17 (34%), segmental resection and anastomosis in 12 (24%), ileostomy and strictureplasty in six (12%) each, repair of perforation in five (10%) and adhesiolysis in four (8%) patients. Overall mortality was 8% due to septicaemia and multiorgan failure. Abdominal Tuberculosis is a significant clinical entity with lethal complications in neglected cases. It affects a younger age group and is more common in females. Clinical features are rather non-specific but vague ill health, low grade fever, weight loss and anorexia may help to diagnose the case. (author)

  19. Effect of rectal distension on abdominal girth.

    Marino, B; Ogliari, C; Basilisco, G

    2004-08-01

    It has been postulated that a viscerosomatic reflex activated by gut distension and inhibiting abdominal wall muscle tone may be one of the mechanisms underlying functional abdominal distension. Any demonstration of such a reflex has to take into account the fact that gut distension may increase abdominal girth as a result of volume displacement. As biomechanical and sensory rectal responses vary at different rates of rectal distension, we hypothesized that different rates of rectal distension might reveal different changes in abdominal girth. Abdominal girth was continuously recorded in 14 healthy subjects using a previously validated extensometer. The rectal distensions were made in a randomized order at rates of 100 mL min(-1) or 10 mL min(-1) up to 150 mL, and sham distensions were used as controls. An increase in abdominal girth was observed at the end of both distensions (P

  20. Cranial radiotherapy predisposes to abdominal adiposity in survivors of childhood acute lymphocytic leukemia

    Advances in treatment of acute lymphocytic leukemia increased the likelihood of developing late treatment-associated effects, such as abdominal adiposity, increasing the risk of cardiovascular disease in this population. Cranial radiotherapy is one of the factors that might be involved in this process. The aim of this study was to determine the effect of cranial radiotherapy on adiposity indexes in survivors of acute lymphocytic leukemia. A comparative cross-sectional study of 56 acute lymphocytic leukemia survivors, chronological age between 15 and 24 years, assigned into two groups according to the exposure to cranial radiotherapy (25 irradiated and 31 non-irradiated), assessed according to body fat (dual energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, lipid profile, and insulin resistance. Cranial radiotherapy increased body fat and abdominal adipose tissue and altered lipid panel. Yet, lipids showed no clinical relevance so far. There were significantly more obese patients among those who received cranial radiotherapy (52% irradiated versus 22.6% non-irradiated), based on dual energy X-ray absorptiometry body fat measurements. Nonetheless, no association was observed between cranial radiotherapy and body mass index, waist circumference, waist-to-height ratio or insulin resistance. Adolescent and young adult survivors of childhood acute lymphocytic leukemia showed an increase in body fat and an alteration of fat distribution, which were related to cranial radiotherapy. Fat compartment modifications possibly indicate a disease of adipose tissue, and cranial radiotherapy imports in this process