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Sample records for abdominal compartment syndrome

  1. Abdominal Compartment Syndrome

    OpenAIRE

    Ovchinnikov V.А.; Sokolov V.А.

    2013-01-01

    We considered one of the most complicated problems of surgery and intensive care — abdominal compartment syndrome. It is a severe, and in some cases lethal complication developing in major injuries and pathology of abdominal cavity and retroperitoneal space, as well as in extra-abdominal pathology. In addition, compartment syndrome can be the complication of a number of surgical procedures accompanied primarily by laparotomy wound closure with tissue tension. We demonstrated the classificatio...

  2. Abdominal Compartment Syndrome

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    Pınar Zeyneloğlu

    2015-04-01

    Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.

  3. Abdominal Compartment Syndrome due to OHSS

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    Firoozeh Veisi

    2012-03-01

    Full Text Available Abdominal compartment syndrome is a dangerous clinical situation, usually following abdominal injuries&operations. It is seldom observed in patients with gynecologic and obstetric problems. Abdominalcompartment syndrome may be consequence ovarian hyperstimulation syndrome. A 28-year-old womanpresented as a sever ovarian hyperstimulation.The increased IAP indicated that OHSS may beconsidered a compartment syndrome. Abdominal compartment syndrome needs laparotomy orparacentesis for reduction of pressure.

  4. Abdominal Compartment Syndrome: pathophysiology and definitions

    OpenAIRE

    Cheatham Michael L

    2009-01-01

    Abstract "Intra-abdominal hypertension", the presence of elevated intra-abdominal pressure, and "abdominal compartment syndrome", the development of pressure-induced organ-dysfunction and failure, have been increasingly recognized over the past decade as causes of significant morbidity and mortality among critically ill surgical and medical patients. Elevated intra-abdominal pressure can cause significant impairment of cardiac, pulmonary, renal, gastrointestinal, hepatic, and central nervous ...

  5. Well Leg Compartment Syndrome After Abdominal Surgery

    DEFF Research Database (Denmark)

    Christoffersen, Jens Krogh; Hove, Lars Dahlgaard; Mikkelsen, Kim Lyngby;

    2016-01-01

    BACKGROUND: Well leg compartment syndrome (WLCS) is a complication to abdominal surgery. We aimed to identify risk factors for and outcome of WLCS in Denmark and literature. METHODS: Prospectively collected claims to the Danish Patient Compensation Association (DPCA) concerning WLCS after abdominal...

  6. Abdominal compartment syndrome. Interesting aspects.

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    Nicolás Rubio Silveira

    2004-04-01

    Full Text Available The management of the abdominal compartiment syndrome is still a controversial point nowadays. Its early diagnosis and treatment constitute a challenge for surgeons and physicians at the intensive care unit who have to face these cases . The physiopathologic changes that can occur can lead to the patients death, constituting pulmonary thromboembolism and multiorgan failure the principal causes of death. This paper presents the principal clinical parameters and technical procedures for its diagnosis and treatment with the aim of diminishing its morbi-mortality raits in our hospitals

  7. [Intraabdominal hypertension and abdominal compartment syndrome

    DEFF Research Database (Denmark)

    Sonne, M.; Hilligsø, Jens Georg

    2008-01-01

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...

  8. Decompressive laparotomy for abdominal compartment syndrome

    Science.gov (United States)

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  9. Abdominal compartment syndrome from bleeding duodenal diverticulum

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    Vakhtang Tchantchaleishvili

    2012-01-01

    Full Text Available Duodenal diverticuli are acquired false diverticuli of unknown etiology. Although mostly asymptomatic, they can occasionally cause upper gastrointestinal hemorrhage, rarely with massive bleeding. In this report, we present (to the best of our knowledge the first reported case of duodenal diverticular bleeding, causing abdominal compartment syndrome. Albeit a rare event, duodenal diverticular bleeding should be included in the differential diagnosis of upper gastrointestinal bleeding. As with our case, a multidisciplinary approach to managing such patients is crucial.

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

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    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

  11. Abdominal compartment syndrome successfully treated with neuromuscular blockade

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    Kris T Chiles

    2011-01-01

    Full Text Available A 48 year old male admitted to the intensive care unit after a cardiac arrest complicated by a stroke intra-operatively during automatic implantable cardioverter defibrillator placement. He post-operatively developed a rigid abdomen, elevated peak and plateau pressures, hypoxia and renal insufficiency. He was diagnosed with abdominal compartment syndrome with an intra-abdominal compartment pressure of 40mmHg. The patient was administered 10 mg of intravenous cisatracuriumbesylate in preparation for bedside surgical abdominal decompression. Cisatracurium eliminated the patients need for surgical intervention by reducing his abdominal compartment pressures to normal and improving his hypoxia and renal function. This case illustrates that neuromuscular blockade should be attempted in patients with abdominal compartment syndrome prior to surgical intervention.

  12. The abdominal compartment syndrome : A complication with many faces

    NARCIS (Netherlands)

    Berger, P.; Nijsten, MWN; Paling, JC; Zwaveling, JH

    2001-01-01

    Background: Lately renewed attention has been given to the abdominal compartment syndrome. Despite of this there still remain a lot of controversies with regard to the pathophysiological mechanisms underlying this syndrome and the therapeutic options. Methods: Two cases of patients with this syndrom

  13. A New Etiology for the Abdominal Compartment Syndrome: Pseudomyxoma Peritonei

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    Charles Sabbagh

    2015-09-01

    Full Text Available Pseudomyxoma peritonei (PMP is a rare diagnosis with an incidence of 1-2 per million. Most cases originate from an appendix which ruptures and releases mucin into the peritoneal cavity. The progression of the disease results in obstruction and cutaneous leak. Abdominal compartment syndrome is an uncommon complication of peritoneal pseudomyxoma. In the present article, we report the case of a patient with PMP and abdominal compartment syndrome. A laparotomy to decrease the abdominal pressure was performed. Three months later, a peritonectomy with hyperthermic intraperitoneal chemotherapy was performed. The patient was still alive 1 year after the procedure without any recurrence. In conclusion, acute abdominal pain and respiratory failure in patients with peritoneal PMP should lead to the measurement of the abdominal pressure but are not a contra indication for curative treatment of PMP.

  14. Abdominal compartment syndrome in acute pancreatitis: a systematic review

    NARCIS (Netherlands)

    Brunschot, S. van; Schut, A.J.; Bouwense, S.A.W.; Besselink, M.G.; Bakker, O.J.; Goor, H. van; Hofker, S.; Gooszen, H.G.; Boermeester, M.A.; Santvoort, H.C. van

    2014-01-01

    Abdominal compartment syndrome (ACS) is a lethal complication of acute pancreatitis. We performed a systematic review to assess the treatment and outcome of these patients.A systematic literature search for cohorts of patients with acute pancreatitis and ACS was performed. The main outcomes were num

  15. Abdominal Compartment Syndrome in Acute Pancreatitis : A Systematic Review

    NARCIS (Netherlands)

    van Brunschot, Sandra; Schut, Anne Julia; Bouwense, Stefan A.; Besselink, Marc G.; Bakker, Olaf J.; van Goor, Harry; Hofker, Hendrik; Gooszen, Hein G.; Boermeester, Marja A.; van Santvoort, Hjalmar C.

    2014-01-01

    Abdominal compartment syndrome (ACS) is a lethal complication of acute pancreatitis. We performed a systematic review to assess the treatment and outcome of these patients. A systematic literature search for cohorts of patients with acute pancreatitis and ACS was performed. The main outcomes were nu

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

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

    2016-01-01

    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, in particula

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

    DEFF Research Database (Denmark)

    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...

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

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    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.

  20. Compartment syndromes

    Institute of Scientific and Technical Information of China (English)

    Aly Saber

    2014-01-01

    Body compartments bound by fascia and limited by bony backgrounds are found in the extremities, buttocks, abdomen and thoracic cavity; conditions that cause intracompartmental swelling and hypertension can lead to ischemia and limb loss.Although compartment syndromes are described in all body regions from head to toe, the etiology, diagnosis, treatment, and prevention are best characterized for three key body regions: the first is extremity, the second is abdominal, and the third is thoracic compartment syndromes.Thoracic compartment syndrome usually occurs as a result of pathological accumulation of air, fluid or blood in the mediastinum and has traditionally been described in trauma.As the intracranial contents are confined within a rigid bony cage, any increase in volume within thiscompartment as a result of brain oedema or an expanding traumatic intracranial haematoma, leads to a reciprocal decrease in the volume of cerebrospinal fluid and intracranial venous blood volume.Limb compartment syndromes may present either in acute or chronic clinical forms.Intra-abdominal pressure can be measured by direct or indirect methods.While the direct methods are quite accurate, theyare impractical and not feasible for routine practice.Indirect measurement is done through inferior vena cava, gastric, rectal and urinary bladder.Indirect measurement through urinary bladder is the simplest and is considered the method of choice for intra-abdominal pressure measurement.The management of patients with intra-abdominal hypertension is based on four important principles: the first is related to the specific procedures aiming at lowering intra-abdominal pressure and the consequences of intra-abdominal hypertension and abdominal compartment syndrome; the second is for general support and medical management of the critically ill patient; while the third is surgical decompression and the fourth is optimization after surgical decompression.

  1. Hemorrhoid sclerotherapy with the complication of abdominal compartment syndrome: report of a case

    Institute of Scientific and Technical Information of China (English)

    YANG Peng; WANG Ya-jun; LI Fei; SUN Jia-bang

    2011-01-01

    The complications of injection sclerotherapy for hemorrhoid are always local. Herein, we report a case in which a female patient with abdominal compartment syndrome developed after receiving a local injection of a sclerosing agent for hemorrhoid.

  2. CASE REPORT An Unusual Case of Abdominal Compartment Syndrome Following Resection of Extensive Posttraumatic Mesenteric Ossification

    OpenAIRE

    Nabulyato, William M.; Alsahiem, Hebah; Hall, Nigel R; Malata, Charles M.

    2013-01-01

    Introduction: Heterotopic mesenteric ossification is an extremely rare condition, which often follows trauma and is frequently symptomatic. To date, there are no reports in the literature of abdominal compartment syndrome occurring after surgical resection of mesenteric calcification. The present report documents an unusual case of compartment syndrome complicating resection of extensive mesenteric calcification despite abdominal closure with the components-separation technique. Method: A 48-...

  3. CASE REPORT An Unusual Case of Abdominal Compartment Syndrome Following Resection of Extensive Posttraumatic Mesenteric Ossification

    Science.gov (United States)

    Nabulyato, William M.; Alsahiem, Hebah; Hall, Nigel R.; Malata, Charles M.

    2013-01-01

    Introduction: Heterotopic mesenteric ossification is an extremely rare condition, which often follows trauma and is frequently symptomatic. To date, there are no reports in the literature of abdominal compartment syndrome occurring after surgical resection of mesenteric calcification. The present report documents an unusual case of compartment syndrome complicating resection of extensive mesenteric calcification despite abdominal closure with the components-separation technique. Method: A 48-year-old man undergoing components-separation technique for posttraumatic laparostomy hernia repair (ileostomy reversal and sigmoid stricture correction) was found to have extensive heterotopic mesenteric calcification, which needed resection. Results: Resection of the mesenteric calcification was complicated by intraoperative hemorrhage and unplanned small bowel resection. Later the patient developed secondary hemorrhage leading to an abdominal compartment syndrome, which was successfully treated by decompression, hemostasis, and Permacol-assisted laparotomy wound closure. The patient remains symptom-free more than 2 years after surgery. Discussion: The case herein reported gives an account of the rare occurrence of abdominal compartment syndrome following resection of posttraumatic ectopic mesenteric ossifications. It is highly unusual in that it occurred because of “secondary hemorrhage” and despite abdominal closure with the components-separation technique, which had been undertaken precisely to prevent compartment syndrome with direct closure. It therefore highlights the need for continued clinical vigilance in complex posttraumatic cases. PMID:23573333

  4. Decompressive Abdominal Laparotomy for Abdominal Compartment Syndrome in an Unengrafted Bone Marrow Recipient with Septic Shock

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    Derrick J. N. Dauplaise

    2010-01-01

    Full Text Available Objective. To describe a profoundly immunocompromised (panleukopenia child with septic shock who developed abdominal compartment syndrome (ACS and was successfully treated with surgical decompression. Design. Individual case report. Setting. Pediatric intensive care unit of a tertiary children's hospital. Patient. A 32-month-old male with Fanconi anemia who underwent bone marrow transplantation (BMT 5 days prior to developing septic shock secondary to Streptococcus viridans and Escherichia coli ACS developed after massive fluid resuscitation, leading to cardiopulmonary instability. Interventions. Emergent surgical bedside laparotomy and silo placement. Measurements and Main Results. The patient's cardiopulmonary status stabilized after decompressive laparotomy. The abdomen was closed and the patient survived to hospital discharge without cardiac, respiratory, or renal dysfunction. Conclusions. The use of laparotomy and silo placement in an unengrafted BMT patient with ACS and septic shock did not result in additional complications. Surgical intervention for ACS is a reasonable option for high risk, profoundly immunocompromised patients.

  5. Abdominal compartment syndrome%腹腔间隔室综合征

    Institute of Scientific and Technical Information of China (English)

    吕云福

    2003-01-01

    @@ 腹腔间隔室综合征(abdominal compartment syndrome,ACS)是指因各种原因引起腹内高压(Intra-abdominal hy-per,IAH)导致心血管、肺、肾、腹腔内脏、腹壁和颅脑等功能障碍或衰竭的综合征.ACS以腹内高压、严重腹胀为特征,其临床表现酷似肠梗阻,也可视其为肠梗阻的一种特殊类型.

  6. Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Zhao-Xi Sun; Hai-Rong Huang; Hong Zhou

    2006-01-01

    AIM: To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine (e.g. Dahuang) in treating abdominal compartment syndrome of fulminant acute pancreatitis.METHODS: Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group (group 1) and control group (group 2). Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE Ⅱ scores were applied for analysis.RESULTS: On the second and fifth days after treatment,APACHE Ⅱ scores of group 1 and 2 patients were significantly different. Comparison of effectiveness (abdominalgia and burbulence relief time, hospitalization time)between groups 1 and 2 showed significant difference,as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated (r = 0.552, 0.748, 0.923, P <0.01) with APACHE Ⅱ scores.CONCLUSION: Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration (SWH), gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.

  7. Diagnosis and Management of Severe Acute Pancreatitis Complicated with Abdominal Compartment Syndrome

    Institute of Scientific and Technical Information of China (English)

    陶京; 王春友; 陈立波; 杨智勇; 许逸卿; 熊炯炘; 周峰

    2003-01-01

    Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered.Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7 %) while in the later, 4 (80%)died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.

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

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    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.

  9. Epstein-Barr virus associated secondary hemophagocytic lymphohistiocytosis with an unusual presentation of abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    Li Lei; Camilla J. Cobb; Jeffrey Cao; Anwar S. Raza

    2016-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a cytokine storm syndrome caused by an overactive but ineffective immune reaction. Without prompt diagnosis and treatment, HLH is life-threatening. However, presenting symptoms are often nonspeciifc, with fatigue and fever being the most common. A high index of suspicion is therefore critical for early diagnosis and timely management. A previously healthy, 65-year-old female who initially presented with fever and abdominal pain developed abdominal compartment syndrome (ACS) requiring decompressive laparotomy on hospital day 6. Intraoperative frozen sections of biopsied liver showed intense portal lymphohistiocytic inifltrates. Epstein-Barr virus DNA copy numbers escalated from 600 copies/ mL after admission to 134,000 copies/mL before death. The diagnostic criteria of HLH-2004 were met. Patient expired on hospital day 12. It is important to raise awareness of ACS being an unusual presentation of HLH. Recent changes in diagnostic criteria tailored to adult HLH cases are reviewed.

  10. [Abdominal compartment syndrome: survey on the awareness of Portuguese general surgeons].

    Science.gov (United States)

    Costa, Sílvia; Gomes, Aline; Graça, Susana; Ferreira, António; Fernandes, Gonçalo; Esteves, Joana; Costa, Alexandre; Fernandes, Paula; Castelões, Paula; Maciel, Jorge

    2011-12-01

    The Abdominal Compartment Syndrome (ACS) is a clinical entity recognized for over a century, but only recently its risk criteria, monitorization and treatment have been defined by the World Society of the Abdominal Compartment Syndrome (WSACS). The general surgeon's involvement is vital since this syndrome is common in surgical patients and because its treatment may culminate in a laparostomy. 250 questionnaires of 17 questions were distributed among general surgeons attending the XXVIII Portuguese Congress of Surgery. The data were analyzed using SPSS® v16. We received 36,4% (91) of the delivered questionnaires, most of which from male surgeons (63,7%), from central hospitals (75,8%), working 42 h per week (70.3%), whose average of age was 38 years. About half of the respondents received training in Intensive Care Units. All surgeons had already heard about measuring the Intra- abdominal Pressure (IAP), which was being performed at 89% of their hospitals. About 40% of surgeons only admitted intra-abdominal hypertension above 20 mmHg (only 22% indicated the correct value of 12 mmHg). 36,3% of surgeons suggested that a decompressive laparostomy must be carried out for primary ACS if IAP greater then 20 mmHg with new organ failure; 36.3% favoured the "Vacuum-pack"-like system, and 56% only re-operate the patients "as needed". 48,4% of surgeons had already performed decompressive laparostomy, 66% of which had residence training in a ICU (p = 0,005). Respondents also pointed an average mortality related to ACS of 81% without laparostomy, and a reduction to 38,5% after performing that procedure. Only 26% of the surgeons were aware of the WSACS consensus definitions and recommendations, of those, 83% had already performed a laparostomy (Pdivulgation.

  11. Compartment syndromes

    Science.gov (United States)

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

    1989-01-01

    The compartment syndrome is defined as a condition in which high pressure within a closed fascial space (muscle compartment) reduces capillary blood perfusion below the level necessary for tissue viability'. This condition occurs in acute and chronic (exertional) forms, and may be secondary to a variety of causes. The end-result of an extended period of elevated intramuscular pressure may be the development of irreversible tissue injury and Volkmann's contracture. The goal of treatment of the compartment syndrome is the reduction of intracompartmental pressure thus facilitating reperfusion of ischaemic tissue and this goal may be achieved by decompressive fasciotomy. Controversy exists regarding the critical pressure-time thresholds for surgical decompression and the optimal diagnostic methods of measuring intracompartmental pressures. This paper will update and review some current knowledge regarding the pathophysiology, aetiology, diagnosis, and treatment of the acute compartment syndrome.

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

    Institute of Scientific and Technical Information of China (English)

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

    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.METHODS: Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2h and external use of Glauber's salt, once a day for 7d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE Ⅱ scores were applied in analysis.RESULTS: On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group (P<0.05). On days 3-5 of treatment, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores for the study and control groups were significantly different (P<0.05). Both the effectiveness and outcome of the treatment with Da Cheng Qi Decoction on abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P<0.05). The mortality rate for the two groups had no significant difference.CONCLUSION: Da Cheng Qi Decoction enema and external use of Glauber's salt combined with routine non-operative conservative treatment can decrease the intra-abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAR.

  13. Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

    Institute of Scientific and Technical Information of China (English)

    Jian-cang ZHOU; Hong-chen ZHAO; Kong-han PAN; Qiu-ping XU

    2011-01-01

    This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) among intensive care physicians in tertiary Chinese hospitals. A postal twenty-question questionnaire was sent to 141 physicians in different intensive care units (ICUs). A total of 108 (76.6%) questionnaires were returned. Among these, three quarters worked in combined medical-surgical ICUs and nearly 80% had primary training in internal or emergency medicine. Average ICU beds, annual admission,ICU length of stay, acute physiology and chronic health evaluation (APACHE) Ⅱ score, and mortality were 18.2 beds,764.5 cases, 8.3 d, 19.4, and 21.1%, respectively. Of the respondents, 30.6% never measured intra-abdominal pressure (IAP). Although the vast majority of the ICUs adopted the exclusively transvesicular method, the over-whelming majority (88.0%) only measured IAP when there was a clinical suspicion of IAH/ACS and only 29.3% measured either often or routinely. Moreover, 84.0% used the wrong priming saline volume while 88.0% zeroed at reference points which were not in consistence with the standard method for IAP monitoring recommended by the World Society of Abdominal Compartment Syndrome. ACS was suspected mainly when there was a distended ab-domen (92%), worsening oliguria (80%), and increased ventilatory support requirement (68%). Common causes for IAH/ACS were "third-spacing from massive volume resuscitation in different settings" (88%), "intra-abdominal bleed-ing", and "liver failure with ascites" (52% for both). Though 60% respondents would recommend surgical decompres-sion when the IAP exceeded 25 mmHg, accompanied by signs of organ dysfunction, nearly three quarters of re-spondents preferred diuresis and dialysis. A total of 68% of respondents would recommend paracentesis in the treatment for ACS. In conclusion, urgent systematic education is absolutely necessary for most intensive care physi

  14. [The influence of modern plasma substitutes on the course of abdominal compartment syndrome in patients with abdominal sepsis].

    Science.gov (United States)

    Kursov, S V

    2013-01-01

    The changes of intra-abdominal pressure (IAP) were followed up in 244 patients with abdominal sepsis after operation. The influence of liquid "resuscitation" with different types of plasma substitutes on the rates of IAP was studied and the dependence of changes IAP from filling of vascular bed was investigated. The impedance technique was used to determine the circulating blood volume and its percentage from proper index was estimated according to the sex, age and constitution. The percentage of interstitial liquid in organism was calculated by analogy. The severity of manifestations of abdominal compartment syndrome (ACS) increases with the assessment of severity of the general condition to APACHE-II scale. The most severe ACS course was while using the crystalloid solutions in the complex of infusion therapy. The inclusion of colloids in the infusion therapy facilitated more full volume filling of vascular bed with the liquid, reduced the capillary leakage, accelerated the process of reduction of ACS. The advantage was shown by using the derivatives of hydroxyethylstarch, which promoted the elimination of deficiency of intravascular liquid in the best way.

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

    Institute of Scientific and Technical Information of China (English)

    Zhi-Gang Deng; Jian-Yin Zhou; Zhen-Yu Yin; You-Yuan Peng; Fu-Qiang Wang; Xiao-Min Wang

    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).METHODS: We presented our recent experience in 8 patients with SAP. The patients developed clinical ACS, which required abdominal decompression. During the operation, a DDS was inserted into the peripancreatic artery (the catheter was inserted from the right gastroepiploic artery until it reached the junction between the pancreaticoduodenal and gastroduodenal artery). Through this DDS, a protease inhibitor, antibiotics and octreotide were infused continuously. The duration of the regional artery infusion ranged from 8 to 41 d. The outcomes and the changes in the APACHE Ⅱ score, computed tomography (CT) severity index and intra-abdominal pressure (IAP) of the patients were retrospectively evaluated.RESULTS: Eight patients with an initial APACHE Ⅱscore of 18.9 (range, 13-27) and a Balthazar CT severity index of 9.1 (range, 7-10) developed severe local and systemic complications. These patients underwent subsequent surgical decompression and CRAI therapy because of intra-abdominal hypertension (IAH). After a mean interval of 131.9 ± 72.3 d hospitalization, 7 patients recovered with decreased APACHE Ⅱ scores, CT severity indexes and IAP. The mean APACHE Ⅱ score was 5.4 (range, 4-8), the CT severity index was 2.3 (range, 1-3), and IAP decreased to 7.7 mmHg (range,6-11 mmHg) 60 d after operation. One patient died of multiple organ failure 1 wk after surgery.CONCLUSION: CRAI and laparotomic decompression might be a therapeutic option for SAP patients with ACS.

  16. Early recognition of abdominal compartment syndrome in patients with acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Zilvinas Dambrauskas; Audrius Parseliunas; Antanas Gulbinas; Juozas Pundzius; Giedrius Barauskas

    2009-01-01

    AIM: To assess the value of widely used clinical scores in the early identification of acute pancreatitis (AP) patients who are likely to suffer from intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). METHODS: Patients ( n = 44) with AP recruited in this study were divided into two groups (ACS and non-ACS) according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter. On admission and at regular intervals, the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems: Glasgow-Imrie score, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE-Ⅱ) score, and Multiorgan Dysfunction Score (MODS). The diagnostic performance of scores predicting ACS development, cut-off values and specificity and sensitivity were established using receiver operating characteristic (ROC) curve analysis. RESULTS: The incidence of ACS in our study population was 19.35%. IAP at admission in the ACS group was 22.0 (18.5-25.0) mmHg and 9.25 (3.0-12.4) mmHg in the non-ACS group ( P 7; MODS > 2 or Glasgow-Imrie score > 3).

  17. Understanding of Abdominal Compartment Syndrome among Turkish Pediatric Healthcare Providers: A Questionnaire Study

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    Naci Topaloğlu

    2014-03-01

    Full Text Available Introduction: To establish the recognition and knowledge of intra-abdominal hypertension (IAH/Abdominal Compartment Syndrome (ACS among Turkish pediatric health care providers (PHCP. Material Methods: A questionnaire was mailed to general pediatricians, pediatric intensivists and pediatric surgeons from different Turkish hospitals.Results:The response rate was 44.5%. Although 86.5% of participants have taken care of intensive care patient, only 34.3% had knowledge about ACS. 86.7% (13/15 of pediatric intensivists, 66.1% (37/56 of pediatric surgeons and 10.3% (11/107 of general pediatricians have had knowledge about ACS. Intra-vesical route was the most common method used to measure intra-abdominal pressure (IAP. Of the respondents, 44.4% measure IAP in patients expected to develop ACS.Conclusions: Turkish PHCP are not familiar enough with ACS. Education is absolutely necessary for PHCP in Turkey to establish clear diagnostic criteria and appropriate management for this life-threatening condition.

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

    LENUS (Irish Health Repository)

    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.

  19. 腹腔间隔室综合征研究进展%Advance of abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    程凯; 杨振林

    2008-01-01

    This review is to provide an overview of current situation and advance of abdominal compartment syndrome. Progress has been made in diagnosis and therapy of abdominal compartment syndrome. At present patients who are diagnosed as abdominal compartment syndrome are associated with a high mortality rate. Therefove, it is important to diagnoze and treat the disease early. Surgical treatment of increased intraabdominal pressure leads in most instances to a rapid and profound correction of the physiological abnormalities. Operative treatment is the unique and effective approach of abdominal compartment syndrome.%随着基础医学和临床医学研究的进展,人们对腹腔高压危害性的认识逐渐加深.腹腔间隔室综合征在病因、诊断、治疗等方面有了较大进步.但目前研究认为,腹腔间隔室综合征病死率仍很高.因此,早期及时发现和正确治疗以取得最佳治疗效果,显得很重要,唯一有效的方法为开腹减压,本文对腹腔间隔室综合征的研究进展作一综述.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. A Sleeve Gastrectomy Complicated by Mesenteric Vein Thrombosis, Abdominal Compartment Syndrome and Pulmonary Emboli: Case Report

    Directory of Open Access Journals (Sweden)

    Erika Leung

    2015-09-01

    Full Text Available Background: Obesity is a growing problem all over the world, including the United States. Single-incision laparoscopic sleeve gastrectomy is a surgery performed for patients who want to lose weight. The number of deaths resulting from thromboembolic complications from bariatric surgeries continues to be of major concern. Case Description: A 38-year-old female was admitted for single incision sleeve gastrectomy and was discharged home three days later. Subsequently she began to have abdominal pain, nausea and vomiting. A CT scan revealed superior mesenteric vein thrombosis with small bowel ischemia, splenic infarction and main and right portal vein branch thrombosis. An exploratory laparotomy demonstrated necrotic bowel due to abdominal compartment syndrome, and an area of small bowel was resected due to internal hernia. Surgical management of the patient during her second hospital stay included a decompressive laparotomy, internal hernia reduction, a small bowel resection. Discussion: Superior mesenteric vein thrombosis can be a life-threatening complication and present with non-specific presentations; thus, it is imperative that it is identified and managed promptly as these cases carry significant morbidity and mortality. Obese patients who undergo bariatric surgery frequently have other co-morbidities; many of which can complicate a case further. Mesenteric vein thromboses are normally treated with unfractionated or low-molecular-weight heparin.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  3. 创伤与腹腔间隙综合征%Injury and abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    何颜霞

    2009-01-01

    @@ 腹腔间隙综合征(abdominal compartment syndrome,ACS)是由于持续腹内压升高所致的严重器官功能障碍状态.早在1863年Mary就已观察到腹腔内高压症(intro-abdominal hypertension,IAH)对呼吸功能的影响,1890年Heinricius在动物模型中证实腹内压27~46 cmH_2O(1 cmH_2O=0.098 kPa)可导致致命性呼吸衰竭.1911年,Emerson首次报道了在多种动物模型中腹内高压可导致心血管功能的异常.1913年Wendt提出腹内高压与肾功能的关系.后来,Baggot报道肠胀气情况下强行关闭腹腔有很高的病死率.

  4. Abdominal compartment syndrome: Incidence and prognostic factors influencing survival in Singapore

    Directory of Open Access Journals (Sweden)

    Chok Aik-Yong

    2014-01-01

    Full Text Available Aim of Study: Abdominal compartment syndrome (ACS is a distinct clinical entity in the critically ill-patient, which leads to end-organ dysfunction. However, data on the incidence of ACS is scarce, and this is also likely contributed by under-diagnosis of this clinical condition. This study reports all cases of ACS in a tertiary institution in Singapore over 10 years, and evaluates prognostic factors affecting survival. Materials and Methods: This retrospective clinical study included 17 patients with ACS, of which 13 underwent decompressive laparotomy, over a 10 years period. Univariate and multivariate analyses of prognostic factors predicting mortality was performed using Chi-square or Fisher-exact test as appropriate. Results: Mean arterial pressure was significantly improved postoperatively, and intra-abdominal pressure and positive end-expiratory pressure significantly decreased. Overall mortality was 47.1%. Advanced age of more than 65 years, gender, large volume resuscitation of more than 3.5 L over 24 h, three or more co-morbidities, requirement of inotropes, usage of mechanical ventilation, and the presence of concurrent lung and renal dysfunction were not adverse prognostic indicators of poorer outcome. The occurrence of multiple relook laparotomies was shown to be the only independent prognostic factor predicting a favorable outcome among these patients on univariate and multivariate analyses. The incidence of ACS accounts for only 0.1% of all Intensive Care Unit admissions during the study period of 10 years, likely due to under-diagnosis. Conclusion: We believe that a protocol for a focused measurement in high-risk groups will increase the diagnostic yield of this condition. Multiple laparotomies for abdominal decompression can lead to improved survival.

  5. Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

    Institute of Scientific and Technical Information of China (English)

    Hong Chen; Fei Li; Jia-Bang Sun; Jian-Guo Jia

    2008-01-01

    AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of LAH/ACS and outcome.METHODS: Patients (n=74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n=44) with IAP≥12 mmHg were assigned in IAH group, and the remaining patients (n=30) with IAP<12mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality.RESULTS: LAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18±3.90 vs 15.70±4.25, P=0.616; 3.70±0.93 vs 3.47±0.94, P=0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period of the first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r=0.635, P<0.001). Although ACS patients had obvious amelioration in physiological variables within 24h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P<0

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 再论腹腔间隙综合征%Reiteration on abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    肖光夏

    2008-01-01

    Since we called for the attention of the occurrence of abdominal compartment syndrome in 2002,forty cases of this complication have been recognized and reported by six burn units in this journal,including three cases accompanied with massive pleural effusion(1601~3240 mL).Most cases emerged after"aggressive"fluid resuscitation,especially after massive infusion of crystalloid fluid.The idea"more fluid no harm"should be corrected.The goal of early fluid resuscitation in burn is to correct the hypovolemia and cell hypoxia,and circulating fluid just serves as a carrier in bringing O2 to the cells and carrying out CO2 and other metabolites from tissues.In face of"leaking while infusing",heavy accumulation of fluid in the third spaces may worsen the cell hypoxia.Some of the parameters we get from invasive monitoring systems can be misleading.Now,the trend of overloading should be prevented,and it behaves us to study the regime of lower fluid volume with proper contents in burn shock resuscitation.

  8. Perforated second trimester appendicitis with abdominal compartment syndrome managed with negative pressure wound therapy and open abdomen.

    Science.gov (United States)

    Turnock, Adam R; Fleischer, Brian P; Carney, Martin J; Vanderlan, Wesley B

    2016-06-14

    Abdominal compartment syndrome (ACS) is a known complication of laparotomy; however, the literature is lacking in regards to treatment of this entity in pregnant patients. We present a case of acute perforated appendicitis in a second trimester primagravida, complicated by gangrenous necrosis of the contiguous bowel with subsequent development of ACS and intra-abdominal sepsis. This was treated with a novel approach, using non-commercial negative pressure wound therapy and open abdomen technique. Gestational integrity was preserved and the patient went on to experience a normal spontaneous vaginal delivery. At 5 years post-delivery the patient has had no surgical complications and her baby has met all developmental milestones.

  9. Abdominal compartment syndrome%腹腔筋膜室综合征

    Institute of Scientific and Technical Information of China (English)

    舒先涛; 王兵

    2004-01-01

    腹腔筋膜室综合征(abdominal compartment syndrome,ACS)是指任何原因引起的腹腔压力急剧升高所导致的消化道、肝脏等腹内脏器及心、肺、肾、脑等腹外器官的血液循环障碍,进而出现一系列病理生理变化所形成的一种临床综合征。“compartment”的本意为间隔、区分,

  10. Progress of abdominal compartment syndrome%腹腔间隔室综合征研究进展

    Institute of Scientific and Technical Information of China (English)

    孟凡亮

    2011-01-01

    腹腔间隔室综合征并非单一疾病,而是由多种原因所造成的症候群,其发病急骤、病情危重、病死率极高,本文就此综合征研究进展做一综述.%Abdominal compartment syndrome (ACS) is not a single disease, but a series of symptoms resulted from multiple causes. ACS has such features as critical onset, serious clinical manifestation and high mortality. This article reviewed the research progress of ACS.

  11. 腹腔间隔室综合征研究进展%Progress of research on abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    施新岗; 李兆申

    2003-01-01

    @@ 腹腔间隔室综合征(abdominal compartment syndrome,ACS)指腹腔内高压(intra-abdominal hypertension,IAH)伴发多器官功能障碍(multiple organs failure,MOF)引起的临床综合征.根据ACS的病因不同,分原发性ACS和继发性ACS.原发性ACS是指由腹膜炎、肠麻痹或腹腔、盆腔创伤等引起,而继发性ACS是主要由外科手术勉强关腹引起.不同病因ACS的发病率不同,目前还没有ACS准确的发病率.

  12. Surgical management of a large peritoneal pseudocyst causing acute kidney injury secondary to abdominal compartment syndrome in a rare case of congenital absence of omentum during pregnancy.

    Science.gov (United States)

    Jones, Benjamin P; Hunjan, Tia; Terry, Jayne

    2016-09-01

    Complete congenital absence of the omentum is very rare with only one previously reported case. We present a unique case of the management of a pregnant woman with a large pelvic pseudocyst caused by complications related to congenital absence of omentum, resulting in acute kidney injury, likely secondary to acute compartment syndrome. This case highlights the importance of considering acute compartment syndrome in critically unwell pregnant women and reiterates the need to measure intra-abdominal pressure when clinically indicated. Given that pregnancy is in itself a state of intra-abdominal hypertension, obstetricians should maintain a high index of suspicion in the context of additional risk factors.

  13. A prospective evaluation of CT features predictive of intra-abdominal hypertension and abdominal compartment syndrome in critically ill surgical patients

    Energy Technology Data Exchange (ETDEWEB)

    Al-Bahrani, A.Z. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); Abid, G.H. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); Sahgal, E. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); O' Shea, S. [Department of Radiology, Manchester Royal Infirmary, Manchester (United Kingdom); Lee, S. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); Ammori, B.J. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom)]. E-mail: bammori@btinternet.com

    2007-07-15

    Aim: The aim of this study was to validate the computed tomography (CT) features of intra-abdominal hypertension (IAH) by relating them to the clinical measurement of intra-abdominal pressure (IAP) in critically ill surgical patients. Materials and methods: The intra-vesical pressure was measured to reflect IAP in 24 critically ill patients. CT examinations obtained within 24 h of IAP measurement were reviewed and scored independently by two consultant radiologists. Each CT examination was scored for the seven proposed features of IAH. Images obtained during the presence of IAH were compared with those obtained in the absence of IAH. Results: Forty-eight abdominal CT examinations were evaluated, of which 18 (38%) were obtained in the presence of IAH, whereas eight (17%) were obtained in the presence of abdominal compartment syndrome (ACS). At CT, the round belly sign (RBS) and bowel wall thickening with enhancement (BWTE) were significantly more frequently detected during the presence of IAH than when the IAP was less than 12 mmHg (78 versus 20% of examinations, p < 0.001 and 39 versus 3% of examinations, p = 0.003, respectively), but only BWTE was significantly associated with the presence of ACS (40 versus 11% of examinations, p = 0.047). Conclusion: The presence of RBS and BWTE on CT images of critically ill surgical patients should alert clinicians to the possibility of presence of IAH and ACS, and prompt measurement of the IAP and consideration of suitable interventions.

  14. Transverse laparostomy is feasible and effective in the treatment of abdominal compartment syndrome in severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Hienonen Piia

    2008-01-01

    Full Text Available Abstract Background Only recently has the important role of abdominal compartment syndrome (ACS been recognized as a contributing factor to the multiple organ failure commonly seen in severe acute pancreatitis (SAP. Decompressive laparostomy for ACS is a life-saving procedure usually performed through a midline incision followed by a negative pressure wound dressing. High risk of intestinal fistulas and frequent inability to close the fascia with ensuing planned ventral hernia has prompted the search for alternative techniques. Subcutaneous fasciotomy may be effective in early and less severe cases of ACS but it is always accompanied with a ventral hernia. Case report A patient with SAP developed manifest ACS and was treated with bilateral subcostal laparostomy. Immediately after decompression, the intra-abdominal pressure dropped from 23 mmHg to 10 mmHg, and the respiratory, cardiovascular and renal functions improved markedly leading to full recovery. The abdominal incision including the fascia and the skin was closed gradually over 4 relaparotomies, and during the 6 months' follow up there are no signs of ventral hernia or other wound complications. Discussion Transverse subcostal laparostomy is a promising alternative decompression technique for ACS in SAP. It is feasible, effective and might provide a chance of early fascial closure. Comparative studies are needed to define its role as a decompressive technique for ACS.

  15. Line of Thinking in ICD-10 Coding of Abdominal Compartment Syndrome%腹腔间隔室综合征的ICD-10编码探讨

    Institute of Scientific and Technical Information of China (English)

    伍英; 彭志刚; 陈红; 黄俐明

    2015-01-01

    本文从概念、定义和ICD1-10编码规则入手,对室隔综合征的临床分型(创伤性骨筋膜室综合征、青光眼、颅内高压综合征、心包填塞、腹腔间隔室综合征)和ICD-10分类之间关系进行了分析对比,提出腹腔间隔室综合征也应与其他室隔综合征同理,编码到消化系统疾病相应章节,即K92.8亚目下。%Based on the concepts, definitions, and coding rules of ICD-10, our studying analyzed and compared the relationship between clinical types and ICD-10 clas ifications of abdominal compartment syndrome, and discus ed the thinking line in ICD-10 Coding of abdominal compartment syndrome . Compartment syndrome divided into the fol owing groups: abdominal compartment syndrome, intracompartment syndrome,intracranial hypertension syndrome, glaucoma, cardiac tamponade. Intracompartment syndrome should be coded to T79.6, intracranial hypertension syndrome:G93.2. glaucoma:H40.0-H40.9,H42.0-H42.8. cardiac tamponade:131.9, so abdominal compartment syndrome should be coded to K92.8 based its interestinal system .

  16. Acute Abdominal Compartment Syndrome as a Complication of Percutaneous Nephrolithotomy: Two Cases Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Jing Tao

    2016-09-01

    Full Text Available Percutaneous nephrolithotomy (PCNL is a technique commonly used to remove large or multiple kidney stones and stones in the inferior calyx, with the advantages of lower morbidity rates, decrease in post-operative pain with faster recovery. Intra-abdominal irrigation fluid extravasation which leads to abdominal hypertension is a rare complication of PCNL with little reports. Early detection of intra-abdominal extravagation is very important to prevent morbidity and mortality. We present two cases and review the literature.

  17. 关于腹腔内高压与腹腔间室综合征的认识演变%Understanding of the Evolution on lntra-abdominal Hypertension and Abdominal Compartment Syndrome

    Institute of Scientific and Technical Information of China (English)

    齐艳

    2012-01-01

    Intra — abdominal hypertension may cause Abdominal Compartment Syndrome. Abdominal Compartment Syndrome is one of the major causes of death of critically ill patients. By analyzing the different periods of intra—abdominal hypertension and abdominal compartment syndrome, understand the risk of intra —abdominal hypertension and ACS, to promote awareness and attention of the medical staff, conducive to early detection, early prevention of 1AH developing ACS.%腹腔内高压可直接导致腹腔间室综合征,腹腔间室综合征是危重患者死亡的重要原因之一.通过分析不同时期对腹腔内高压和腹腔间室综合征的认识,了解腹腔内高压和腹腔间室综合征的危险性,以促进医护人员的认识和重视,利于早发现、早预防IAH发展为ACS.

  18. Anastomotic leak management after a low anterior resection leading to recurrent abdominal compartment syndrome: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Toutouzas Kostas

    2009-11-01

    Full Text Available Abstract Introduction Low anterior resection is usually the procedure of choice for rectal cancer, but a series of complications often accompany this procedure. This case report describes successful management of an intricate anastomotic leak after a low anterior resection. Case presentation A 66-year-old Caucasian man was admitted to our hospital and diagnosed with a low rectal adenocarcinoma. He underwent a low anterior resection but subsequently developed fecal peritonitis due to an anastomotic leak. He was operated on again but developed abdominal compartment syndrome, multi-organ failure and sepsis. He was aggressively treated in the intensive care unit and in the operating room. Overall, the patient underwent four laparotomies and stayed in the intensive care unit for 75 days. He was discharged after 3 months of hospitalization. Conclusion Abdominal compartment syndrome may present as a devastating complication of damage control laparotomy. Prompt recognition and goal-directed management are the cornerstones of treatment.

  19. 腹内高压症和腹腔间隙综合征%Intro-abdominal hypertention and abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    何颜霞

    2006-01-01

    腹内压升高可导致多系统器官功能障碍乃至衰竭。早在1863年Mary就已观察到腹内高压症(intro-abdominal hypertension, IAH)对呼吸功能的影响。1890年Heinndus通过动物模型证实腹内压20~34mmHg(1mmHg=0.133kPa=1.36cmH2O)可导致致命性呼吸衰竭。1911年,Emerson首次报道了在多种动物模型中IAH可导致心血管功能的异常。1913年Wendt提出IAH与肾功能的关系。后来,Baggot报道肠胀气情况下强行关闭腹腔有很高的病死率。直到1980年Kon和他的同事首先提出了腹腔间隙综合征(abdominal compartment syndrome, ACS)的概念,用来描述腹内压增高后对心血管、肺、肾、胃肠、脑等多系统器官功能的影响。此后,IAH和AGS逐步被外科和成人重症监护医生所认识和重视。但儿科医生对其了解和认识仍不多。该综合征在儿科并非罕见,且病死率高达60%。本文对此作一介绍。以扩展儿科医生对危重患儿的诊断和治疗思路。

  20. Spontaneous Thigh Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Khan, Sameer K

    2011-02-01

    Full Text Available A young man presented with a painful and swollen thigh, without any history of trauma, illness, coagulopathic medication or recent exertional exercise. Preliminary imaging delineated a haematoma in the anterior thigh, without any fractures or muscle trauma. Emergent fasciotomies were performed. No pathology could be identified intra-operatively, or on follow-up imaging. A review of thigh compartment syndromes described in literature is presented in a table. Emergency physicians and traumatologists should be cognisant of spontaneous atraumatic presentations of thigh compartment syndrome, to ensure prompt referral and definitive management of this limb-threatening condition. [West J Emerg Med. 2011;12(1:134-138].

  1. 重视烧伤后腹腔间隙综合征%To Think Highly of Abdominal Compartment Syndrome after Burns

    Institute of Scientific and Technical Information of China (English)

    肖光夏

    2006-01-01

    凡因腹内压增高导致心血管、肺、肾、胃肠以及颅脑等多器官系统的功能障碍称为腹腔间隙综合征(Abdominal Compartment Syndrome,ACS).不及时减压可能是一致死性的并发症,但多年来被忽略,近几年来开始引起临床的关注。

  2. Current Diagnosis and Treatment of Abdominal Compartment Syndrome%腹腔间隔室综合征的诊治现状

    Institute of Scientific and Technical Information of China (English)

    贾乾斌

    2003-01-01

    @@ 腹腔间隔室综合征(abdominal compartment syndrome, ACS)是一个近百年来未引起重视的问题.19世纪末至20世纪初, Marey、Heinricios和Wendt等发现,腹内压升高到27~46 cmH2O时可导致动物呼吸功能不全、心血管功能紊乱和肾功能不全,甚至死亡.

  3. Compartment syndrome without pain!

    LENUS (Irish Health Repository)

    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. Animal model of the abdominal compartment syndrome as a single insult and as a second insult in rats Modelo experimental de síndrome de compartimento abdominal como insulto único e como um segundo insulto, em ratos

    Directory of Open Access Journals (Sweden)

    João Baptista de Rezende-Neto

    2003-01-01

    Full Text Available The objective of this paper was to develop a clinically relevant abdominal compartment syndrome experimental model, as a single insult and as a second insult flowing hemorrhagic shock. In the single insult model, Sprague-Dawley male-rats are anesthetized, invasively monitored (central venous pressure and mean arterial pressure, and mechanically ventilated during intraperitoneal injection of air to provoke the abdominal compartment syndrome (25 mmHg for 60 minutes. In the two insult model, Sprague-Dawley male-rats are anesthetized, invasively monitored (mean arterial pressure and bled to a mean arterial pressure of 30 mmHg for 45 minutes. Fluid resuscitation is accomplished by infusing 0.9% sodium chloride solution (0.9% NaCl 33.2 ml/kg plus 75% of shed blood volume. During this phase a laparotomy is performed. Two hours after the beginning of the hemorrhagic shock phase the animals are anesthetized, intubated (orotracheal, mechanically ventilated (mean arterial pressure, and the intra-abdominal pressure is increased to 25 mmHg for 60 minutes, as a second insult. A 0.9% NaCl solution is infused during this phase (45 ml/kg/h. Hemorrhagic shock and the abdominal compartment syndrome behave as clinically relevant additive insults.Este artigo propõe o desenvolvimento de um modelo experimental, clinicamente relevante, de síndrome de compartimento abdominal como insulto único e como segundo insulto após choque hemorrágico. No modelo de insulto único, ratos Sprague-Dawley machos, anestesiados, sob monitorização invasiva da pressão venosa central, pressão arterial média e ventilação mecânica são submetidos a síndrome de compartimento abdominal (25 mmHg por 60 minutos através da injeção de ar na cavidade peritoneal. No modelo de dois insultos ratos Sprague-Dawley machos, anestesiados, sob monitorização invasiva da pressão arterial média, são submetidos a choque hemorrágico (30 mmHg por 45 minutos seguido de reposição vol

  5. Chronic anconeus compartment syndrome: A case report.

    Science.gov (United States)

    Steinmann, S P; Bishop, A T

    2000-09-01

    Compartment syndrome of the forearm is commonly associated with the volar compartment. We present a case of compartment syndrome of the anconeus muscle. Release of the anconeus muscle fascia provided relief of symptoms.

  6. 5例腹腔间室综合征病人的护理%Nursing care of 5 patients with abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    臧莉; 杨慧英; 杨媛; 高芳宁; 段思源

    2010-01-01

    @@ 腹腔间室综合征(abdominal compartment syndrome,ACS)是因各种原因引起腹内高压导致心血管、肺、肾、胃肠道及颅脑等功能障碍或衰竭的综合征[1],常发生于肠梗阻、腹腔出血、腹部闭合性损伤、出血性胰腺炎、腹腔感染等情况时.临床上以严重腹胀合并少尿、呼吸窘迫为主要特征,若得不到及时有效的处理,往往导致心血管、肺、肾、内脏和颅脑等脏器的功能障碍或衰竭导致病人死亡.我科自2007年以来收治了5例重度ACS的病人,现将护理介绍如下.

  7. Relationship of abdominal compartment syndrome and multiple organs failure in patients underwent abdominal surgery%腹部手术患者并发腹腔间室综合征与多脏器功能衰竭的关系

    Institute of Scientific and Technical Information of China (English)

    王林; 李丰

    2011-01-01

    Objective To analyze the correlation between abdominal compartment syndrome and multiple organ failure in the patients underwent abdominal surgery. Methods Data of 344 patients underwent abdominal surgery were analyzed retrospectively,who were divided into 2 groups of A(66 cases,with abdominal compartment syndrome) and B(278 cases, without abdominal compartment syndrome). The correlation between abdominal compartment syndrome and multiple organ failure was analyzed. Results Of 66 patients in group A,40 cases were complicated with abdominal compartment syndrome with the incidence rate of 60.61% ,which was significantly higher than 23. 02%(64/278) in group B(P<0.01). The incidence of abdominal compartment syndrome was positively correlated with multiple organ failure (r=0.322, P<0.01). Conclusion The incidence of abdominal compartment syndrome is closely related with multiple organ failure in the patients underwent abdominal surgery.%目的 分析腹部手术患者并发腹腔间室综合征与多脏器功能衰竭的相关性.方法 回顾性分析344例腹部手术患者资料,其中,并发腹腔间室综合征66例(A组),无腹腔间室综合征278例(B组).比较两组患者并发多脏器功能衰竭的发生情况.结果 A组患者有40例发生多脏器功能衰竭,发生率为60.61%(40/66),明显高于B组的23.02%(64/278)(P<0.01).Spearman相关分析显示,腹部手术患者并发腹腔间室综合征与多脏器功能衰竭具正相关(r=0.322,P<0.01).结论 腹部手术患者并发腹腔间室综合征患者容易发生多脏器功能衰竭.

  8. 维库溴铵治疗腹腔间隔室综合征的临床价值研究%Clinical study of using vecuronium treat patients with abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    罗建宇; 王晓源; 蒋文芳; 蔡天斌

    2015-01-01

    目的:探讨维库溴铵治疗腹腔间隔室综合征( abdominal compartment syndrome, ACS)的临床价值及对预后的影响。方法将ICU中40例ACS患者随机分为治疗组与对照组(每组20例)。对照组采取抗感染、胃肠减压、镇静镇痛、促胃肠动力药物、机械通气、血液净化、外科手术等常规治疗,治疗组在对照组基础上加用肌松剂(维库溴铵)间断静注或持续微量泵输注。观察、对比使用维库溴铵治疗对腹腔压力、腹腔灌注压、血压、血乳酸、尿量、氧合指数、C反应蛋白、APACHEⅡ评分、ICU住院时间及病死率的影响及相互变化的关系。结果维库溴铵能明显降低腹腔压力、腹腔灌注压和血乳酸水平(P<0.05),提高氧合指数(P<0.05),但对入住ICU时间及病死率无明显影响。结论维库溴铵可明显改善ACS患者的腹腔压力,短期内可延缓病情进展,但对总体预后无明显影响。%Objective To investigate the clinical value of using vecuronium treat patients with abdominal compartment syndrome and the factors that affect prognosis.Methods Forty cases with abdominal compartment syndrome in the ICU were randomly divided into treatment group (20 cases) and control group (20 cases).Patients in control group were treated by anti -infection, gastrointestinal decompression, sedation, prokinetic drugs, mechanical ventilation, blood purification, surgery and other conventional treatment. Based on the above treatment, treatment group using muscular blockers vecuronium intermittent intravenous infusion or continuous micro -pump.Dynamic change of intra -abdominal pressure, abdominal perfusion pressure, blood pressure, blood lactate, urine output, oxygenation index, C-reactive protein levels, APACHEⅡ score were determined, and ICU stay and hospital mortality were recorded and compared between the two groups.Results For patients with abdominal compartment syndrome

  9. 小儿腹间隔综合征15例临床分析%Clinical analysis of 15 cases of abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    赵生奎; 魏晓明

    2010-01-01

    @@ 腹间隔综合征(abdominal compartment syn-drome,ACS)是腹腔内高压持续一定时间后导致的多个器官功能不全甚至衰竭.在临床上可表现为严重腹胀、通气障碍、难治性高碳酸血症、肾功能不全等.目前该病的报道较少见.

  10. Nursing of pregnancy with pancreatitis complicated with abdominal compartment syndrome%妊娠合并胰腺炎并发腹腔间隙综合征的护理

    Institute of Scientific and Technical Information of China (English)

    刘小利; 何纪恩; 乔丽娜; 张琳

    2009-01-01

    @@ 妊娠合并急性胰腺炎(acute pancreatitis,P)属外科急重症.重症胰腺炎急性反应期常伴有毛细血管渗漏,上妊娠妇女本身腹腔容积的改变,出现腹腔内压力(intraabdominalpressure,AP)升高,着疾病的发展和液体复苏的进行,后可发生腹腔间隙综合征(abdominal compartment syndrome,ACS).

  11. 出血性休克复苏中诱发腹腔间隔综合征的临床分析%Clinical Analysis of Abdominal Compartment Syndrome Induced by Hemorrhagic Shock Resuscitation

    Institute of Scientific and Technical Information of China (English)

    陈荣鑫

    2015-01-01

    Objective:To analyze the abdominal compartment syndrome induced by hemorrhagic shock resuscitation. Methods: In the 10 cases of abdominal compartment syndrome admitted by our hospital in recent years,4 patients had car accident,2 were stabbed,1 fell from great height,and 3 had accidents in constructionn site.All abdominal compartment syndrome of the patients were caused by hemorrhagic shock resuscitation. Information of all patients before and after surgery were collected and analyzed. Results: In the clinical treatment of the 10 patients,4 patients had fascia compartment syndrome, five patients were cured,3 patients survived and 2 patients died. Conclusions: The hemorrhagic shock resuscitation should be done under detailed monitoring.The patient's bladder pressure is an important monitoring indicator,because it is helpful for the early detection and treatment of abdominal compartment syndrome,so as to increase the survival rate of the patients.%目的:探讨出血性休克复苏中诱发患者出现腹腔间隔综合征的临床分析。方法:在最近几年中我院收治出现腹腔间隔综合征患者10例,其中有4例患者为车祸所致,2例患者是刺伤,1例患者为高空坠落,3例患者为工地意外,患者出现腹腔间隔综合征均是由出血性休克复苏所致,对所有患者的进行手术前后的资料进行整合分析。结果:在10例患者的临床治疗中发现,其中有4例患者为合并筋膜间隔综合征,其中治疗痊愈患者5例,有3例患者存活,有2例患者死亡。结论:在出血性休克患者的临床进行复苏时,需要在详细监控中进行操作,其中监测的主要指标包括患者的膀胱内压,有助于早期及时发现患者出现的腹腔间隔综合征,并进行治疗,从而有效提高患者的生存率。

  12. Clinical aspects of lower leg compartment syndrome

    NARCIS (Netherlands)

    Brand, Johan Gerard Henric van den

    2004-01-01

    A compartment syndrome is a condition in which increased pressure within a limited space compromises the circulation and function of tissues within that space. Although pathofysiology is roughly similar in chronic exertional and acute compartment syndrome of the lower leg, the clinical presentation

  13. 布-加综合征继发腹腔间隔室综合征的处理%Management of Budd-Chiari syndrome complicated with abdominal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    卢秀波; 马秀现; 许培钦; 许雅娟

    2001-01-01

    Objective To study the mechanism and management of abdominal compartment syndrome (ACS) in patients with Budd Chiari Syndrome (BCS).Methods 42 patients with BCS complicated with ACS were diagnosed by venography and intraabdominal pressure measurement. All patients were treated with ascities dialysis and influsion before operation. Portosystemic shunt was performed on 36 patients, and interventional procedures were conducted to recanalize the occluded main hepatic vein(MHV) on 6 patients. Results In this series, 2 patients died postoperatively and 2 patients had no good results in long term follow-up; the clinical features disappeared or markedly alleviated in the others. Conclusions MHV occlusion is the primary pathologic change of BCS complicated with ACS. Portosystemic shunt operation or MHV recanalization by interventional therapy can relieve the symptoms of BCS with ACS.%目的探讨布-加综合征(BCS)病人并发腹腔间隔室综合征(ACS)的发病机制和处理。方法 42例病人经静脉造影和腹内压测定确诊为BCS并有ACS。所有病人术前行腹水透析和回输,而后行各种门体分流术(36例)或介入主肝静脉再通术(6例)。结果除2例死亡、2例病人远期疗效稍差外,其余38例BCS并ACS的临床症状消失或明显减轻。结论主肝静脉阻塞是BCS并ACS的主要病理学改变;门体分流术或经介入方法使主肝静脉再通可消除BCS并ACS的症状。

  14. Decompressive laparotomy in the treatment of severe acute pancreatitis complicated with abdominal compartment syndrome%开腹减压治疗重症急性胰腺炎并发腹腔间室综合征

    Institute of Scientific and Technical Information of China (English)

    朱维铭; 龚剑峰

    2008-01-01

    Abdominal compartment syndrome(ACS)is an important factor contributing to the multiple organ dysfunction syndrome which is commonly seen in patients with severe acute pancreatitis(SAP).As a life-saving procedure,decompressive laparotomy is widely applied to patients with SAP complicated with ACS,especially to patients with edema of the visceral tissues caused by massive fluid resuscitation at the early stage of the disease.However,decompressive laparotomy should be adopted with caution since it is associated with enteroatmospherie fistula,intraabdominal infection,postoperative ileus,third space losses,hypothermia and hemia.Therefore,decompressive laparotomy should only be considered after conservative management had failed.The indications for decompressive laparotomy are as follows:(1)intraabdominal pressure>25 nnn Hg;(2)adequate ventilation of the patient is difficult;(3)pereutaneous drainage of ascites is not helpful.Timely temporal abdominal closure is helpful in preventing complications.Infected peripanereatie necrosis is the indication for peripancreatic exploration or necroseetomy.A thorough knowledge of decompressive laparotomy is essential for individualized management of patients with SAP complicated with ACS.

  15. [Fascia compartment syndrome of the iliac-psoas compartment].

    Science.gov (United States)

    Klammer, A

    1983-01-01

    The iliacus compression syndrome has a kind of exceptional position--as to genesis, development and therapy--in comparison with the other compartment-compression syndromes of the limbs. Indeed there exist similar pathophysiological, rules, but the special anatomic facts enlarge the etiological, differential-diagnostic and therapeutic spectrum. Thus, concerning the frequency of causes, not the trauma but the spontaneous bleeding in coagulation disturbances takes the first place, and unusual causes, such as rupturing aortic aneurysms, have to be included in the differential diagnostic discussion. The finest diagnostic sign besides pain is the palsy of the Nervus Femoralis. As to the treatment, operative measures are possible. The exact knowledge of the anatomy is important for the understanding of the specialties mentioned above.

  16. Cutaneous anthrax cases leading compartment syndrome

    Directory of Open Access Journals (Sweden)

    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

  17. Microscopic and ultrastructural changes of the intestine in abdominal compartment syndrome%腹腔间隙综合征小肠黏膜显微和超微结构改变的观察

    Institute of Scientific and Technical Information of China (English)

    赵允召; 龚冠文; 李宁; 黎介寿

    2011-01-01

    Objective Direct damages that ahdominal compartment syndrome ( ACS) inflicts on intestinal mucosal barrier could he intestinal mucosal ischemia and dilatation of the intestinal tight junction ( TJ). The purpose of the study was to examine the microscopic changes of intestinal villi and ultrastructural changes of TJ in the presence of intra-abdominal hypertension ( LAH) of 20 mmHg, and to investigate the relationship of intestinal villus damage with ultrastructural changes of TJ and ACS. Methods Forty Sprague-Daley rats weighing (250 ± 25) g were equally divided into a control and three experimental groups , the latter subjected to intra-abdominal pressure of 20 mmHg for 1 , 2 and 4 hours , respectively. The specimens of the intestine were obtained and submitted to histopathologic examination by HE staining and to ultrastructural analysis under the scanning electron microscope. Results The histopathologic study revealed different degrees of changes ranging from swelling and degeneration of villous epithelial cells to extensive denudation and collapse of the villus. Ultrastructural analysis showed the dilatation of TJ and paracellular spaces in the presence of IAH.The severity of the damage was related to the time of IAH. Conclusion Increased IAH caused significant damage to the intestinal epithelium and marked dilatation of intestinal TJ , leading to the increased mucosal barrier permeability, which may explain the frequent association uf IAH with bacterial translocation and sepsis.%目的 腹腔间隙综合征(abdominal compartment syndrome,ACS)对肠黏膜屏障功能的直接损害有2种可能:肠黏膜缺血和肠黏膜细胞间紧密连接的破坏.文中通过观察20mmHg(1mmHg=0.133kPa)腹腔高压(intra-abdominal hypertension,IAH)状态下小肠绒毛光镜下结构以及细胞间紧密连接(tight junction,TJ)超微结构(电镜)的变化,找到IAH与肠黏膜和TJ变化间的关系,从而为IAH导致细菌易位找到证据.方法 SD

  18. Acute exertional anterior compartment syndrome in an adolescent female.

    Science.gov (United States)

    Fehlandt, A; Micheli, L

    1995-01-01

    Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

  19. 承气汤治疗腹腔间隔室综合征临床研究%Clinical Study of Chengqi Decoction in Treating Abdominal Interval Compartment Syndrome

    Institute of Scientific and Technical Information of China (English)

    把永忠

    2013-01-01

    Objective:To explore the clinical efficacy of Chengqi Decoction in treating abdominal interval compartment syndrome (ACS).Methods:60 cases of ACS patients were divided into the treatment group and the control group according to random number table blind method.The control group was given stop bleeding,anti-infection,fasting,gastrointestinal decompression,soapy water enema,breathing,circulation support treatment,nutritional support treatment,and patients combined with renal failure were treated with renal failure resistant.the treatment group was additionally given Chengqi Decoction base on the control group.(Composition:raw rhubarb(later) 15-30 g,mirabilite(administered after dissolved) 10 g,Mangnolia officinalis 10 g,fructus aurantii immaturus 10 g,salviae miltiorrhizae 30 g,costusroot 10 g,betel nut 20 g,rhizoma corydalis10 g).Results:Peristalsis recovery time and defecation time of the treatment group were significantly improved,and were better than those of the control group.Comparison intra-abdominal pressure changes of survived cases in the two groups showed that the difference was statistically significant(P <0.05),and the treatment group was superior than the control group.Conclusion:Chengqi Decoction in treating abdominal interval compartment syndrome has remarkable effect.%目的:探讨承气汤治疗腹腔间隔室综合征(ACS)的临床疗效.方法:将60例ACS患者按随机数字表法随机分为治疗组和对照组30例.对照组予以止血、抗感染,禁食、胃肠减压、肥皂水灌肠,呼吸、循环支持治疗,营养支持治疗,合并肾功能衰竭患者采用抗肾功能衰竭治疗.治疗组在对照组基础上加用承气汤[方药组成:生大黄(后下)15~ 30 g,芒硝(冲服)10 g,厚朴10 g,枳实10 g,丹参30 g,木香10 g,槟榔20 g,延胡索10 g]治疗.结果:治疗组患者的肠蠕动恢复时间、排便时间明显提高,均明显优于对照组(P<0.05).两组存活病例腹腔内压变化比

  20. Delayed Presentation of Acute Gluteal Compartment Syndrome.

    Science.gov (United States)

    Tasch, James J; Misodi, Emmanuel O

    2016-07-19

    BACKGROUND Acute gluteal compartment syndrome is a rare condition that usually results from prolonged immobilization following a traumatic event, conventionally involving the presence of compounding factors such as alcohol or opioid intoxication. If delay in medical treatment is prolonged, severe rhabdomyolysis may ensue, leading to acute renal failure and potentially death. CASE REPORT We report the case of a 23-year-old male with a recent history of incarceration and recreational drug use, who presented with reports of severe right-sided buttock pain and profound right-sided neurological loss following a questionable history involving prolonged immobilization after a fall from a standing position. The patient required an emergent gluteal fasciotomy immediately upon admission and required temporary hemodialysis. After an extended hospital stay, he ultimately recovered with only mild deficits in muscular strength in the right lower extremity. CONCLUSIONS This report demonstrates the importance of early recognition of gluteal compartment syndrome to prevent morbidity and mortality. Compartment syndrome presents in many unique ways, and healthcare practitioners must have a keen diagnostic sense to allow for early surgical intervention. Proper wick catheter measurements should be utilized more frequently, instead of relying on clinical symptomatology such as loss of peripheral pulses for diagnosis of compartment syndrome.

  1. Gluteal Compartment Syndrome Secondary to Pelvic Trauma.

    Science.gov (United States)

    Diaz Dilernia, Fernando; Zaidenberg, Ezequiel E; Gamsie, Sebastian; Taype Zamboni, Danilo E R; Carabelli, Guido S; Barla, Jorge D; Sancineto, Carlos F

    2016-01-01

    Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

  2. Gluteal Compartment Syndrome Secondary to Pelvic Trauma

    Directory of Open Access Journals (Sweden)

    Fernando Diaz Dilernia

    2016-01-01

    Full Text Available Gluteal compartment syndrome (GCS is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

  3. 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

    Directory of Open Access Journals (Sweden)

    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

  4. 重症急性胰腺炎并发腹腔间室综合征的CT表现%Computed tomographic features of abdominal compartment syndrome complicated by severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    吴晶涛; 朱庆强; 朱文荣; 陈文新; 王守安

    2014-01-01

    目的 探讨重症急性胰腺炎(SAP)并发腹腔间室综合征(ACS)患者的CT特征.方法 回顾性对比分析2005年3月至2013年3月江苏省苏北人民医院36例SAP并发ACS患者(观察组)和61例非ACS(NACS)的SAP患者(对照组)的CT资料,探讨有意义的CT特征.结果 本组36例ACS患者和61例NACS患者,CT扫描,ACS血管并发症包括腹腔及消化道出血的发生率高于NACS(P<0.05).ACS并发纹窄性肠梗阻及肠系膜炎的发生率高于NACS(P <0.05).ACS下腔静脉受压、狭窄(<3 mm),膈肌上抬、圆腹征阳性及大量腹腔积液的发生率高于NACS(P<0.05).ACSBalthazar CT评分(CT SI)高于NACS(P<0.05).与ACS有关的CT征象,出现≥4项有关ACS的CT特征,诊断敏感度96.5% (28/29),特异度100% (7/7),阳性预测值100% (28/28),阴性预测值87.5%(7/8),手术存活率远高于非手术存活率(P<0.05).结论 SAP合并ACS患者有一定的CT特征,充分认识此类征象,可为患者早期诊断及治疗起到积极地指导作用.%Objective To explore the computed tomographic (CT) imaging features of abdominal compartment syndrome (ACS) complicated by severe acute pancreatitis (SAP) to improve the diagnosis of disease.Methods Thirty-six cases of ACS and 61 cases of non-ACS (NACS) complicated by SAP were studied retrospectively.And the meaningful CT features were studied.Results Among them,the ACS vascular complications of abdominal cavity and gastrointestinal bleeding were found significantly more in ACS than in NACS (P < 0.05).The ACS intestinal obstruction occurred significantly more often in ACS than in NACS (P < 0.05).The ACS inferior vena cava pressure,diaphragm elevation,round belly sign and marked seroperitoneum occurred significantly more often in ACS than in NACS (P < 0.05).The score of ACS with Balthazar was higher than that of NACS (P < 0.05).For CT signs associated with ACS,four or more associated with ACS CT characteristics,the diagnostic sensitivity was 96.5

  5. Compartment syndrome can also be seen in the forearm

    DEFF Research Database (Denmark)

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

    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 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....

  6. Abdominal vascular syndromes: characteristic imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D' Ippolito, Giuseppe, E-mail: leandrocleite@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Mediciana. Departmento de Diagnostico por Imagem

    2016-07-15

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital - including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome) - compressive - including 'nutcracker' syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. (author)

  7. The upper hand on compartment syndrome.

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Erickson, Bradley A.; Yap,Ronald L.; Pazona,Joseph F.; Hartigan,Brian J.; Smith, Norm D.

    2007-01-01

    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.

  10. 家兔长时间腹腔内高压致腹腔筋膜室综合征模型的建立及生长抑素的干预作用%Effects of somatostatin in a rabbit model of abdominal compartment syndrome induced by prolonged intra-abdominal hypertension

    Institute of Scientific and Technical Information of China (English)

    陈煜; 薛翔; 王丽; 金春华; 邹衍泰

    2012-01-01

    Objective To establish a rabbit model of abdominal compartment syndrome (ACS) induced by prolonged intra-abdominal hypertension (IAH) and evaluate the therapeutic effect of somatostatin on ACS. Methods Twelve New Zealand rabbits were randomized equally into normal saline (NS) group and somatostatin group. ACS model was established by intra-abdominal bleeding (IAB) and intra-abdominal infusion with nitrogen gas to achieve an intra-abdominal pressure of 15 mmHg. The hemodynamics (SP, HR, CVP), hepatic function (ALT), renal function (BUN), antioxidation level (SOD, MDA) and blood electrolyte level (pH, [Na+], [Cl], [Ca2+], [K+]) of the rabbits were recorded 1-6 h after establishment of IAH. Results Prolonged IAH caused decreased hemodynamic functions and antioxidation level as well as hyperkalemia and hypocalcemia (P<0.05), but these changes showed no significant differences between NS group and somatostatin group. Conclusion Prolonged IAH causes cardiovascular function damages in rabbits possibly related to acidosis, electrolyte disturbances, and oxidative damage due to tissue ischemia and hypoxia. Somatostatin produces no obvious protective effects against the occurrence and progression of ACS.%目的 制作家兔长时间腹腔内高压所致的腹腔筋膜室综合征(ACS)模型,研究较长时间的腹腔内高压征(IAH)对家兔循环功能、肝肾功能、抗氧化能力及血液电解质水平的影响,并观察生长抑素是否对ACS有防治作用.方法 将12只新西兰兔平均分为2组,分别为生理盐水对照组、生长抑素干预组.通过模拟兔腹部失血和注入氮气建立动物IAH/ACS模型.并在IAH15 mmHg后1~6h观察兔各项指标变化,包括动脉收缩压、心率、中心静脉压(CVP)、血液酸碱及电解质指标,同时测定代表肝肾功能的谷丙转氨酶和尿素氮(BUN),以及反映组织过氧化反应的超氧化物歧化酶(SOD)和丙二醛(MDA)的变化情况.结果 长时间的IAH可使机体血压下降

  11. 严重烧伤后并发腹腔间隙综合征与全身炎症反应综合征的相关性%The correlation between systemic inflammatory response syndrome and abdominal compartment syndrome after serious burns

    Institute of Scientific and Technical Information of China (English)

    涂家金; 宋茂林; 徐泽华; 周孝亮; 龙丽芸; 罗文跃

    2012-01-01

    阐述严重烧伤后围休克期并发腹腔间隙综合征(ACS)与全身炎症反应综合征(SIRS)的相关性.临床分析认为,SIRS是致ACS的主要原因之一,ACS是SIRS未及时有效控制和超量补液导致;另从循证医学角度论证ACS发生机制的新认识,认为"单纯补液过多导致ACS"的论断具有片面性;最后对严重烧伤后围休克期并发ACS的治疗提出了切实可行的思路及展望.%To explain the correlation between abdominal compartment syndrome ( ACS ) and systemic inflammatory response syndrome ( SIRS ) on perishock stage after severe burn. By clinical analysis, we hold that the ACS is secondary to SIRS when SIRS did not get timely and effective control or with excessive fluid infusion, and demonstrate the new mechanism of ACS from the point view evidence-based medicine. We believe " rehydration too much lead to ACS" is the one-sided view. Finally, prospect and practical idea are put forward to the treatment of ACS in patients with serious burn during peri-shock stage.

  12. Compartment Syndrome as a Result of Systemic Capillary Leak Syndrome

    Directory of Open Access Journals (Sweden)

    Kwadwo Kyeremanteng

    2016-01-01

    Full Text Available Objective. To describe a single case of Systemic Capillary Leak Syndrome (SCLS with a rare complication of compartment syndrome. Patient. Our patient is a 57-year-old male, referred to our hospital due to polycythemia (hemoglobin (Hgb of 220 g/L, hypotension, acute renal failure, and bilateral calf pain. Measurements and Main Results. The patient required bilateral forearm, thigh, and calf fasciotomies during his ICU stay and continuous renal replacement therapy was instituted following onset of acute renal failure and oliguria. Ongoing hemodynamic (Norepinephrine and Milrinone infusion and respiratory (ventilator support in the ICU was provided until resolution of intravascular fluid extravasation. Conclusions. SCLS is an extremely rare disorder characterized by unexplained episodic capillary hyperpermeability, which causes shift of volume and protein from the intravascular space to the interstitial space. Patients present with significant hypotension, hemoconcentration, hypovolemia, and oliguria. Severe edema results from leakage of fluid and proteins into tissue. The most important part of treatment is maintaining stable hemodynamics, ruling out other causes of shock and diligent monitoring for complications. Awareness of the clinical syndrome with the rare complication of compartment syndrome may help guide investigations and diagnoses of these critically ill patients.

  13. Compartment Syndrome of the Arm After Cable-Wakeboard Accident.

    Science.gov (United States)

    Barendse-Hofmann, Minke G; Steenvoorde, Pascal; van Doorn, Louk; Zeillemaker, Anneke

    2009-02-01

    A compartment syndrome is an increased tissue pressure within a closed osteofascial compartment. This compromises blood flow to the muscles and nerves within that compartment, which -if not treated adequately in an early stage-results in permanent tissue and nerve damage. It most frequently occurs in the lower leg, but can also occur elsewhere when muscles are enclosed in tight fascial compartments, such as the forearm and hand. In this report a patient is described who developed an acute compartment syndrome of the arm after a cable-wakeboard accident in which his arm was strangulated. Cable-wakeboarding is an extreme sport that has become very popular over the last years. Early recognition and treatment of an acute compartment syndrome is of extreme importance since in short term necrotic muscles can lead to severe irreversible complications. Accidents with cable-wakeboarding often occur during the start. This is caused by the strong forces that are on the cable during the start. Strangulation injuries of the arm can cause a compartment syndrome of the arm. Possibly a wet-suit or dry-suit offers some protection. However, the duration of strangulation determines much of the damage. Although diagnosis of a compartment syndrome can be difficult, a high index of suspicion combined with fast and adequate treatment with a fasciotomy improve outcome and prognosis.

  14. Abdominal vascular syndromes: characteristic imaging findings*

    Science.gov (United States)

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D'Ippolito, Giuseppe

    2016-01-01

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital-including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)-or compressive-including "nutcracker" syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. PMID:27777480

  15. Fulminant crural compartment syndrome preceded by psychogenic polydipsia

    DEFF Research Database (Denmark)

    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...

  16. Well-leg compartment syndrome after gynecological laparoscopic surgery

    DEFF Research Database (Denmark)

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

    2013-01-01

    Well-leg compartment syndrome in the lower extremities after surgery in the lithotomy position is a rare but severe complication requiring early diagnosis and intervention. Several circumstances predispose to this condition as a consequence of increased intra-compartmental pressure, such as posit....... Potential risk factors and preventive initiatives are listed to reduce the risk in future patients. We describe two patients who underwent gynecologic laparoscopic surgery and postoperatively developed well-leg compartment syndrome....

  17. Contralateral compartment syndrome inoculated by invasive group A streptococcus

    Directory of Open Access Journals (Sweden)

    Huiwen Chen

    2016-10-01

    Full Text Available Compartment syndrome is a rare but a well-documented complication in patients with trauma-induced group A streptococcus infection. Here, we present a case of a male who developed compartment syndrome on the left lower extremity after an injury inoculated by group A streptococcus on the right lower extremity. The patient was resuscitated with antibiotics, urgent fasciotomy, and immunoglobulin. The patient was eventually transferred to a burn center for further care.

  18. Acral osteolysis in bilateral compartment syndrome

    Directory of Open Access Journals (Sweden)

    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.

  19. Compartment syndrome of the foot in a child.

    Science.gov (United States)

    Sharma, A K; Sharaf, I; Ajay, S

    2001-06-01

    We report a case of a 12-year-old boy with acute compartment syndrome of the foot following a road-traffic accident. Due to the rarity of the injury, there was a delay in diagnosing the injury. An emergency fasciotomy was performed 19 hours after the injury. The foot healed with a mild extension contracture of the second toe.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Dubin, Ina; Gelber, Moshe; Schattner, Ami

    2016-05-01

    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.

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

    DEFF Research Database (Denmark)

    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 limb...

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

    NARCIS (Netherlands)

    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

  4. Acute compartment syndrome of the forearm caused by calcific tendinitis of the distal biceps.

    Science.gov (United States)

    Garayoa, Santiago Amillo; Romero-Muñoz, Luis M; Pons-Villanueva, Juan

    2010-12-01

    Acute compartment syndrome of the forearm requires immediate treatment to avoid damage of the soft tissues and a poor functional outcome for the forearm. Muscular and bone lesions are the main causes of acute compartment syndromes. We report a case of acute compartment syndrome of the forearm caused by a calcific tendinitis of the distal biceps.

  5. Chronic Exertional Compartment Syndrome in a High School Soccer Player

    Directory of Open Access Journals (Sweden)

    James J. Bresnahan

    2015-01-01

    Full Text Available Chronic exertional compartment syndrome (CECS is a relatively rare condition that affects young adult athletes and often causes them to present to the emergency department. If left untreated, those who continue to compete at high levels may experience debilitating leg pain. Physicians may have difficulty differentiating CECS from other syndromes of the lower leg such as medial tibial stress syndrome, stress fractures, and popliteal artery entrapment. The gold standard for diagnosing CECS is intramuscular compartment pressure monitoring before and/or after 10 minutes of exercise. Some patients may choose to stop participation in sports in order to relieve their pain, which otherwise does not respond well to nonoperative treatments. In patients who wish to continue to participate in sports and live an active life, fasciotomy provides relief in 80% or more. The typical athlete can return to training in about 8 weeks. This is a case of a high school soccer player who stopped competing due to chronic exertional compartment syndrome. She had a fascial hernia, resting intramuscular pressure of 30 mmHg, and postexercise intramuscular pressure of 99 mmHg. Following fasciotomy she experienced considerable life improvement and is once again training and playing soccer without symptoms.

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

    Science.gov (United States)

    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

  7. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    Science.gov (United States)

    Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis. PMID:24392235

  8. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration.

    Science.gov (United States)

    Berumen-Nafarrate, Edmundo; Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  9. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    Directory of Open Access Journals (Sweden)

    Edmundo Berumen-Nafarrate

    2013-01-01

    Full Text Available The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  10. Compartment syndrome with mononeuropathies after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kindle, Brett J; Murthy, Naveen; Stolp, Kathryn

    2015-05-01

    Compartment syndrome rarely follows anterior cruciate ligament reconstruction. However, when it does, it may result in mononeuropathies that are amenable to neurolysis. The authors of this study present an 18-yr-old woman who sustained a right anterior cruciate ligament tear and underwent uneventful anterior cruciate ligament reconstruction using femoral and popliteal nerve blocks. Postoperatively, she developed compartment syndrome requiring emergent fasciotomies. At 11 wks after fasciotomy, results of electrophysiologic tests showed evidence of severe fibular and tibial neuropathies. Magnetic resonance images showed extensive tricompartmental myonecrosis. Fibular and tibial neurolysis as well as decompression were performed, followed by intensive outpatient rehabilitation. At the 6-mo follow-up, she reported resolution of pain as well as significant improvement in sensation, strength, and function. Early recognition and intervention are crucial to prevent serious neurologic damage. Excessive tourniquet pressure and anesthetic nerve blocks may have been responsible.

  11. Compartment syndrome after total knee arthroplasty: regarding a clinical case

    Directory of Open Access Journals (Sweden)

    Ana Alexandra da Costa Pinheiro

    2015-08-01

    Full Text Available ABSTRACT Although compartment syndrome is a rare complication of total knee arthroplasty, it is one of the most devastating complications. It is defined as a situation of increased pressure within a closed osteofascial space that impairs the circulation and the functioning of the tissues inside this space, thereby leading to ischemia and tissue dysfunction. Here, a clinical case of a patient who was followed up in orthopedic outpatient consultations due to right gonarthrosis is presented. The patient had a history of arthroscopic meniscectomy and presented knee flexion of 10° before the operation, which consisted of total arthroplasty of the right knee. The operation seemed to be free from intercurrences, but the patient evolved with compartment syndrome of the ipsilateral leg after the operation. Since compartment syndrome is a true surgical emergency, early recognition and treatment of this condition through fasciotomy is crucial in order to avoid amputation, limb dysfunction, kidney failure and death. However, it may be difficult to make the diagnosis and cases may not be recognized if the cause of compartment syndrome is unusual or if the patient is under epidural analgesia and/or peripheral nerve block, which thus camouflages the main warning sign, i.e. disproportional pain. In addition, edema of the limb that underwent the intervention is common after total knee arthroplasty operations. This study presents a review of the literature and signals that the possible rarity of cases is probably due to failure to recognize this condition in a timely manner and to placing these patients in other diagnostic groups that are less likely, such as neuropraxia caused by using a tourniquet or peripheral nerve injury.

  12. Compartment syndrome after total knee arthroplasty: regarding a clinical case.

    Science.gov (United States)

    Pinheiro, Ana Alexandra da Costa; Marques, Pedro Miguel Dantas Costa; Sá, Pedro Miguel Gomes; Oliveira, Carolina Fernandes; da Silva, Bruno Pombo Ferreira; de Sousa, Cristina Maria Varino

    2015-01-01

    Although compartment syndrome is a rare complication of total knee arthroplasty, it is one of the most devastating complications. It is defined as a situation of increased pressure within a closed osteofascial space that impairs the circulation and the functioning of the tissues inside this space, thereby leading to ischemia and tissue dysfunction. Here, a clinical case of a patient who was followed up in orthopedic outpatient consultations due to right gonarthrosis is presented. The patient had a history of arthroscopic meniscectomy and presented knee flexion of 10° before the operation, which consisted of total arthroplasty of the right knee. The operation seemed to be free from intercurrences, but the patient evolved with compartment syndrome of the ipsilateral leg after the operation. Since compartment syndrome is a true surgical emergency, early recognition and treatment of this condition through fasciotomy is crucial in order to avoid amputation, limb dysfunction, kidney failure and death. However, it may be difficult to make the diagnosis and cases may not be recognized if the cause of compartment syndrome is unusual or if the patient is under epidural analgesia and/or peripheral nerve block, which thus camouflages the main warning sign, i.e. disproportional pain. In addition, edema of the limb that underwent the intervention is common after total knee arthroplasty operations. This study presents a review of the literature and signals that the possible rarity of cases is probably due to failure to recognize this condition in a timely manner and to placing these patients in other diagnostic groups that are less likely, such as neuropraxia caused by using a tourniquet or peripheral nerve injury.

  13. Acute Compartment Syndrome of the Thigh in Combat Casualties

    Science.gov (United States)

    2013-03-01

    clinical signs and symptoms alone (27, 28). These signs include pain out of proportion, weakness and passive pain on stretch of the muscles in the...spasm/ cramping /weakness). Thirty-three percent (5/15) have pruritis. Twenty-seven percent (4/15) have symptomatic fascial herniations. Twenty...thigh. J. Orthop. Trauma 16:436–438, 2002. 6. Rooser, B., Bengtson, S., Hagglund, G. Acute compartment syndrome from anterior thigh muscle contusion: a

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

    Directory of Open Access Journals (Sweden)

    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. Deltoid Compartment Syndrome: A Rare Complication after Humeral Intraosseous Access

    Science.gov (United States)

    Thadikonda, Kishan M.; Ma, Irene; Spiess, Alexander M.

    2017-01-01

    Summary: We present a case of a 65-year-old woman who developed a delayed deltoid compartment syndrome after resuscitation via humeral intraosseous access. Initially she was treated conservatively but then was taken emergently for a fasciotomy. After confirming the diagnosis with compartment pressures, a 2-incision approach was employed and a large hematoma was evacuated from the inferior margin of the anterior deltoid. The rest of the deltoid was inspected and debrided to healthy bleeding tissue. Her fasciotomy wounds were left open to heal on their own due to her tenuous clinical condition. At most recent follow-up, she had full range of motion in her shoulder and no residual pain. Our unique case study is the first documented incidence of upper extremity compartment syndrome after intraosseous access. Additionally, our case supports using humeral access only as a second-line option if lower extremity access is not available and prolonged vigilant monitoring after discontinuing intraosseous access to prevent disastrous late complications. PMID:28203508

  16. COMPARTMENTS

    DEFF Research Database (Denmark)

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

    2014-01-01

    Information on protein subcellular localization is important to understand the cellular functions of proteins. Currently, such information is manually curated from the literature, obtained from high-throughput microscopy-based screens and predicted from primary sequence. To get a comprehensive vi...... based on the type and source of the localization evidence. Finally, we visualize the unified localization evidence for a protein on a schematic cell to provide a simple overview. Database URL: http://compartments.jensenlab.org....

  17. Relevance of mangled extremity severity score to compartment syndromes.

    Science.gov (United States)

    Uslu, M M; Altun, N S; Cila, E; Atik, O S

    1995-01-01

    This study investigated the relevance of a mangled extremity severity score (MESS) to the evaluation of intracompartmental pressure in injured patients. We measured intracompartmental pressures with a modification of the Whitesides method and compared these values with MESS in 27 patients after trauma. For 5 of them fasciotomy was necessary to relieve high intracompartmental pressures. In our series MESS seemed to correlate with intracompartmental pressure values (r = 0.733, P MESS system provides objective criteria in determining the risk of a compartment syndrome.

  18. Acute Compartment Syndrome in the Forearm with Trans-Ulnar Single Incision.

    Science.gov (United States)

    Suzuki, Taku; Inaba, Naoto; Sato, Kazuki

    2016-02-01

    We report a case of ulnar nerve palsy caused by diaphyseal fractures of the forearm and acute compartment syndrome. Trans-ulnar single incision with a fasciotomy of the volar and dorsal compartments was used to fix the ulna. Full recovery of the ulnar nerve was achieved six months after the surgery. In cases of acute compartment syndrome with ulnar fracture, a trans-ulnar incision with compartment release is effective for the fixation of the ulna.

  19. Case study: Gluteal compartment syndrome as a cause of lumbosacral radiculoplexopathy and complex regional pain syndrome.

    Science.gov (United States)

    Lederman, Andrew; Turk, David; Howard, Antonio; Reddy, Srinivas; Stern, Michelle

    2016-01-01

    We present the case of a 24 yr old male who was diagnosed with gluteal compartment syndrome and was subsequently found to have developed lumbosacral radiculoplexopathy and complex regional pain syndrome. The patient's gluteal compartment syndrome was diagnosed within 24 h of presentation to the emergency room, and he underwent emergent compartment release. While recovering postoperatively, persistent weakness was noted in the right lower limb. Results of electrodiagnostic testing were consistent with a lumbosacral radiculoplexopathy. After admission to inpatient rehabilitation, the patient complained of pain, burning sensation, and numbness in the distal right lower limb. Based on clinical findings, he was diagnosed with complex regional pain syndrome type II, or causalgia, and was referred for a lumbar sympathetic block under fluoroscopic guidance. Sympathetic block resulted in relief of the patient's symptoms. He was discharged home with good pain control on oral medications.

  20. Upper limb compartment syndrome after an adder bite:a case report

    Institute of Scientific and Technical Information of China (English)

    Mohamed Faouzi Hamdi; Sayed Baccari; Mehdi Daghfous; Lamjed Tarhouni

    2010-01-01

    Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom.Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence.Elevated compartment pressure was documented and immediate sur-gical fasciotomy was practiced.The patient achieved com-plete recovery with a good functional result.We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compart-ment syndrome following adder bites.

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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. A swollen hand with blisters: a case of compartment syndrome in a child.

    Science.gov (United States)

    Rios-Alba, Tonatiuh; Ahn, James

    2015-06-01

    The accurate identification of compartment syndrome in the emergency department is essential to timely treatment and prevention of long-term sequela. Recognizing compartment syndrome is not straightforward, especially in the pediatric population. In addition to communication barriers that exist with children, the classic signs of pain, pallor, paresthesia, paralysis, and pulselessness are not always present, making its diagnosis a challenge. We report a case of a child with compartment syndrome to the left hand due to compression from an ACE wrap. The existing literature on compartment syndrome in children is reviewed.

  4. Idiopathic Acute Isolated Lateral Compartment Syndrome of a Lower Leg: A Magnetic Resonance Imaging Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Dong Heon; Lee, Ji Hae; Cho, Woo Ho; Kim, Jae Hyung; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Ji Young; Kim, Soo Hyun; Kang, Mi Jin; Lee, Han Bee [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Bae, Kyung Eun [Dept. of Radiology, Seoul Asan Hospital, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2013-01-15

    Acute compartment syndrome of the lower leg is usually associated with major trauma such as fracture, and most commonly occurs in the anterior or deep posterior compartments. Isolated lateral compartment syndrome is less typical and usually associated with minor trauma or exertion. There are a few reports of the acute compartment syndrome which develops without an obvious cause. However, there are few reports of idiopathic acute isolated lateral compartment syndrome, and there are no reports of the radiologic findings. This study presents a radiologic finding of idiopathic acute isolated lateral compartment of lower leg, which shows localized enlargement of the peroneal muscles with peripheral convex bowing and change of their signal intensity with fluid signal along the adjacent fascial planes on magnetic resonance imaging.

  5. Compartment syndrome, rhabdomyolysis and risk of acute renal failure as complications of the lithotomy position.

    NARCIS (Netherlands)

    Bocca, G.; Moorselaar, R.J.A. van; Feitz, W.F.J.; Staak, F.H.J.M. van der; Monnens, L.A.H.

    2002-01-01

    Compartment syndrome, rhabdomyolysis and the risk of acute renal failure are potential complications of the lithotomy position. A six-year-old girl is described who developed a compartment syndrome with rhabdomyolysis after prolonged surgery in the lithotomy position. This complication occurred thre

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

    DEFF Research Database (Denmark)

    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.......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....

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete

    Directory of Open Access Journals (Sweden)

    Moo Ing How

    2015-01-01

    Conclusion: A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and “blow-out” tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome.

  9. Deltoid compartment syndrome as a complication of lateral decubitus positioning for contralateral elbow surgery in an anabolic steroid abuser.

    Science.gov (United States)

    Wijesuriya, Julian D; Cowling, Paul D; Izod, Christopher; Burton, David Jc

    2014-07-01

    Compartment syndrome as a result of patient positioning for surgery is a rare but serious complication. Compartment syndrome as a result of anabolic steroid use is more rare. We present a unique case of compartment syndrome related to anabolic steroid use and patient positioning for complex distal humerus fracture fixation and also provide a review of the literature related to this topic.

  10. Deltoid compartment syndrome as a complication of lateral decubitus positioning for contralateral elbow surgery in an anabolic steroid abuser

    OpenAIRE

    2014-01-01

    Compartment syndrome as a result of patient positioning for surgery is a rare but serious complication. Compartment syndrome as a result of anabolic steroid use is more rare. We present a unique case of compartment syndrome related to anabolic steroid use and patient positioning for complex distal humerus fracture fixation and also provide a review of the literature related to this topic.

  11. [Chronic stress-related compartment syndrome of the forearm].

    Science.gov (United States)

    Kouvalchouk, J F; Watin Augouard, L; Dufour, O; Coudert, X; Paszkowski, A

    1993-01-01

    The chronic anterior compartment syndrome of the forearm is a rare pathology (3 cases have been already published), and of new knowledge. Three new cases on 2 patients (one on both sides) are described here. The authors describe recent advances about physiopathology, exploration and surgical treatment. It is due to strenuous activity using flexor muscles of the forearm without any release period (here motor cyclist competition). The symptom was pain at the anterior forearm similar to cramp. The most important for diagnosis was to measure the pressure after activity. The threshold level read after activity was up to 30 mm of Hg, with a very slow coming back to normal value. The isotopic scanner with hydroxyl methylene di-phosphonate (HMDP), after activity, showed a delay of arrival of the tracer and a stasis. RMI seems to give abnormal modification of the signal. The only treatment was surgical and an open fasciotomy of superficial and deep fascia must be done, with opening of the muscle's perimysium. The patients became painfree and resumed their sport after surgical treatment.

  12. Compartment Syndrome following Open Femoral Fracture with an Isolated Femoral Vein Injury Treated with Acute Repair

    Directory of Open Access Journals (Sweden)

    David Walmsley

    2014-01-01

    Full Text Available Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome.

  13. Abdominal Complications after Severe Burns

    Science.gov (United States)

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high

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

    DEFF Research Database (Denmark)

    Larsen, Peter Birk; Jensen, Steffen Skov

    Title: Diagnosis and treatment of chronic exertional compartment syndrome - a proposition for an algorithm based on case series of patients treated at Sports Medicine Division, Department of Orthopaedic Surgery, Viborg Regional Hospital, Denmark Background: Chronic exertional compartment syndrome...... that specific activity induced strain (SAIS) can be used to diagnose the specific affected compartments, and in this way be able to safely and effectively treat this disorder using endoscopic assisted selective fasciotomy (EASF). Materials and Methods: Retrospective follow-up study of 13 consecutive selected...... in conjunction with a thorough medical history formed the basis for the diagnosis. Results: 11 patients were offered surgical treatment consisting of EASF of the affected compartment (10 bilateral and 1 unilateral, 8 affected in specific compartments and 3 affected in all compartments. Only 1 patient required...

  15. Abdominal syndromes and functional ability in the elderly

    DEFF Research Database (Denmark)

    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 occu...... that abdominal syndromes are associated to functional ability, suggesting that there is a diffuse disorder affecting both smooth and striated muscles.......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...

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

    DEFF Research Database (Denmark)

    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....

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

    Science.gov (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Noel, P.B.; Bauer, J.S.; Ganter, C.; Markus, C.; Rummeny, E.J.; Engels, H.P. [Klinikum rechts der Isar, Technische Univ. Muenchen (Germany). Inst. fuer Radiologie; Hauner, H. [Klinikum rechts der Isar, Technische Univ. Muenchen (Germany). Else Kroener-Fresenius-Center for Nutritional Medicine

    2012-06-15

    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.)

  19. Compartment syndrome following total knee replacement: A case report and literature review

    Science.gov (United States)

    Shaath, Mohammed; Sukeik, Mohamed; Mortada, Saadallah; Masterson, Sean

    2016-01-01

    Compartment syndrome is a rare complication of total knee replacement (TKR) surgery that needs prompt diagnosis and treatment as it may be associated with high morbidity and mortality. We have found very few reports in the literature describing compartment syndrome after TKRs and therefore, present a relevant case which occurred in the immediate postoperative phase and was treated with fasciotomy and subsequent operations to close the soft tissue defects. PMID:27672575

  20. CHRONIC COMPARTMENT SYNDROME OF LOWER LEG. AN UNUSUAL CASE IN NON ATHLETIC PATIENT.

    Directory of Open Access Journals (Sweden)

    Andrea Schiavone

    2016-10-01

    Full Text Available Chronic exertional anterior compartment syndrome is debilitating disease of lower limb. The clinical picture is characterised by limited symptomology at rest, pain during sporting activities, tumefaction and contractures of limb as well impotency by pain of the entire forefoot and hypoesthesia. Usually the most affected patients are athletes. We analyse a case of chronic post traumatic compartment syndrome of the anterior tibial muscle in an unsportsmanlike patient.

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

    LENUS (Irish Health Repository)

    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.

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

    Science.gov (United States)

    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.

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

    LENUS (Irish Health Repository)

    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.

  4. Acute Abdominal Pain Secondary to Chilaiditi Syndrome

    Directory of Open Access Journals (Sweden)

    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.

  5. Treatment of compartment syndrome of the thigh associated with acute renal failure after the Wenchuan earthquake.

    Science.gov (United States)

    Duan, Xin; Zhang, Kaiwei; Zhong, Gang; Cen, Shiqiang; Huang, Fuguo; Lv, Jingtong; Xiang, Zhou

    2012-04-01

    Compartment syndrome of the thigh is a rare emergency often treated operatively. The purpose of this study was to evaluate the effects of nonoperative treatment for compartment syndrome of the thigh associated with acute renal failure after the 2008 Wenchuan earthquake. Nonoperative treatment, which primarily involves continuous renal replacement therapy, was performed in 6 patients (3 men and 3 women) who presented with compartment syndrome of the thigh associated with acute renal failure. The mean mangled extremity severity score (MESS) and laboratory data regarding renal function were analyzed before and after treatment, and the clinical outcome was evaluated at 17-month follow-up. Laboratory data regarding renal function showed improvements. All 6 patients survived with the affected lower limbs intact after nonoperative treatment. Follow-up revealed active knee range of motion and increased muscle strength, as well as a recovery of sensation. A positive linear correlation was found between MESS and the time required to achieve a reduction in swelling, as well as the time required for the recovery of sensation and knee range of motion (r>0.8; P<.05). Satisfactory clinical outcomes were obtained in patients with compartment syndrome of the thigh associated with acute renal failure.Urine alkalization, electrolyte and water balance, and continuous renal replacement therapy have played an important role in saving lives and extremities. Nonoperative treatment should be considered in the treatment of compartment syndrome of the thigh associated with acute renal failure.

  6. Lower extremity anterior compartment syndrome complicating bilateral mastectomy and immediate breast reconstruction: A case report and literature review.

    Science.gov (United States)

    Tashakkor, A Yashar; Macadam, Sheina A

    2012-01-01

    'Well leg compartment syndrome' refers to compartment syndrome occurring in a nontraumatic setting. This occurs most commonly in the lower limb during surgery performed with the patient in an anatomically vulnerable position. While this complication is well documented in the setting of orthopedic, urological and gynecological surgeries, it is an exceptionally rare complication in plastic surgery; only seven cases have been published on compartment syndrome complicating an operation performed on a supine patient. A case involving a 56-year-old woman who developed an anterior compartment syndrome of her right lower leg following a bilateral mastectomy with immediate breast reconstruction is presented. A detailed literature review is also included.

  7. Forearm Compartment Syndrome of a Newborn Associated with Extravasation of Contrast Agent

    Directory of Open Access Journals (Sweden)

    Egemen Altan

    2013-01-01

    Full Text Available Extravasation of contrast agents is a possible complication of imaging studies. Although extravasations typically cause minimal swelling or erythema, they can lead to compartment syndrome when the volume of extravasation is high. In this article, we will present an exceptional case where an insignificant amount of contrast agent extravasation led to a forearm compartment syndrome in a newborn, who was treated with an extended fasciotomy. We would like to emphasize the preventive techniques and treatment options of this iatrogenic complication in newborns. Close followup of the patient by the nurses, awareness of the parents and the personnel in the radiology department are the most important preventive measures in this extremity-threatening complication. Forearm compartment syndrome due to contrast agent extravasation may progress more rapidly in newborns even with smaller amounts of extravasation and prompt recognition of the pathology and immediate intervention are unevitable.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement.

    Science.gov (United States)

    Mesfin, Addisu; Lum, Ying Wei; Nayfeh, Tariq; Mears, Simon C

    2011-03-11

    Massive venous thrombosis, which can occur acutely after inferior vena cava filter placement, has 2 forms: phlegmasia cerulea dolens and phlegmasia alba dolens. In phlegmasia cerulea dolens, complete occlusion of venous outflow occurs. In the milder phlegmasia alba dolens version, collateral venous flow out of the limb remains despite the venous thrombosis. This article presents, to our knowledge, the first 2 cases of massive venous thrombosis (1 phlegmasia cerulea dolens, 1 phlegmasia alba dolens) below inferior vena cava filters occurring after the acute period. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Phlegmasia cerulea dolens and phlegmasia alba dolens have high morbidity and mortality. The patient with phlegmasia alba dolens required leg and thigh fasciotomies and eventually required an above-knee amputation. The patient with phlegmasia cerulea dolens developed compartment syndrome in the left leg, right leg, and right thigh. Although he underwent decompression of all of these compartments, he died from multiple organ failure. A multidisciplinary approach with the vascular service and the intensivists is required in the treatment of patients with massive venous thrombosis. Treatment goals include preventing additional propagation of the thrombus via anticoagulation, with strong consideration for catheter-directed thrombolysis or thrombectomy and fasciotomies for compartment syndrome. The orthopedic surgeon should keep phlegmasia cerulea dolens and phlegmasia alba dolens in the differential for compartment syndrome, especially in patients who have had a history of acute or chronic inferior vena cava filter placement.

  10. Profile of Hand Compartment Syndrome in Dr. Hasan Sadikin General Hospital, West Java, 2008−2012

    Directory of Open Access Journals (Sweden)

    Kajendaran Manogaran

    2015-12-01

    Full Text Available Background: Compartment syndrome is a serious disorder caused by elevated pressure in a muscle compartment that can progress to muscle and nerve damage. This disorder can happen to anyone but more frequently in young adults. The occurrence frequency of hand compartment syndrome is relatively low. The aim of this study is to identify the profile of compartment syndrome in patients hand Methods: A descriptive study was perfomed to 15 cases that were collected from medical records from 2008-2012, in Dr. Hasan Sadikin General Hospital. The profile of the case consisted of age, sex, symptoms and signs, etiology, facsiotomy schedule after admission, length of stay and patient’s outcome. The collected data were presented using tables. Results: The study showed that 12 out of 15 cases were males and 7 out of 15 cases were 20−39 years old patients. The common clinical findings were swelling, pain, limited range of motion and normal sensibility. The faciotomy procedure was conducted 1 day after the admission with length of stay more than 1 week. The patients condition were improved after operation. Conclusions: Hand compartment syndrome is a rare case, mostly affects younger adults and male. Most of the symptoms and signs are swelling, limitation of movement, pain in the location area with normal sensibility. The faciotomy procedure is conducted 1 day after admission. The length of stay is more than 1 week with an improved outcome.

  11. Compartment syndrome developed due to the plaster cast :Three cases report

    Directory of Open Access Journals (Sweden)

    Pinar Doruk

    2013-08-01

    Full Text Available Compartment syndrome can occur as a result of the complication of the plaster cast applications ,which are frequently used for fracture stabilization. This syndrome occurs due to increased compartment volume or shrinking of compartment area because of edema, hemorrage or high pressure of tissues. All of these mechanisms causes arteriolar compression, resulting nerve and muscle ischemia. Intensive and continuous pain is common and limits the motions of the patient and increases with passive stretching of the involved muscles. Swelling of limb, change in skin color, peripheral vasculatory failure symptoms such as pallor,weak arterial pulsation and as a result of peripheral nerve damage, sensorimotor deficit can also be observed. Clinical evaluation, measure of pressure within the compartment, and electroneuromyography (ENMG can be used for the diagnosis. In addition to treatment of to the treatment of etiology and pain, further treatment options such as fasciotomy, physiotherapy modalities, tendon transfers, can be performed. In this case report, we will discuss three patients with nerve lesions as a result of the compartment syndrome that developed due to the plaster casting of bone fractures. [Cukurova Med J 2013; 38(4.000: 774-778

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

    Directory of Open Access Journals (Sweden)

    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.

  13. [Regional anaesthesia may be used in selected acute compartment syndrome patients.

    DEFF Research Database (Denmark)

    Jensen, Christine; Kristensen, Billy B

    2011-01-01

    Acute compartment syndrome (ACS) is a serious condition which, if not treated promptly, can cause severe disability or even death. Regional anaesthesia (epidural analgesia or peripheral nerve blocks) is increasingly used in postoperative pain management in orthopaedic surgery, but has been presumed...

  14. The Acute Compartment Syndrome of the Lower Leg: A Difficult Diagnosis?

    NARCIS (Netherlands)

    J. Vlot; M.G. Eversdijk (Martin); D. den Hartog (Dennis); P.P. Oprel (Pim); W.E. Tuinebreijer (Wim)

    2010-01-01

    textabstractThree patients, two adults and one child, developed an acute compartment syndrome of the lower leg. Due to delay in diagnosis, severe complications developed, resulting in two transfemoral amputations. In the youngest patient, the lower leg was able to be saved after extensive reconstruc

  15. [Reconstructive surgery of sequelae of compartment syndrome of the lower leg and/or foot. Presentation of a new classification].

    Science.gov (United States)

    Zwipp, H

    2008-10-01

    The sequelae of an undiagnosed insufficiently treated or unpreventable (by crush injury) compartment or postischemic syndrome, most often after lower leg fracture or popliteal artery injury, are caused by necrosis and contracture of the extrinsic foot muscles. Therefore claw toes, pes equinus or other forms, such as a severe pes equino varus related to the compartment involved will decide the kind of foot deformity. In cases of a combined compartment syndrome of the lower leg and foot, not only the extrinsic but also the intrinsic muscles especially the short flexors are involved, leading to extensive claw toeing of the hallux and the lesser toes as well. In the case of an isolated compartment syndrome of the foot one will see contracted hammer toes most often after open or third degree closed calcaneal fractures. A new classification of all the different deformities of the foot and ankle as sequelae of a compartment and/or postischemic syndrome, is introduced distinguishing 5 degrees of deformity. Between 1994 and 2006, a total of 66 patients with sequelae of a compartment and/or postischemic syndrome were treated at the Department of Trauma and Reconstructive Surgery of the University Hospital"Carl Gustav Carus" of the Technical University of Dresden. Patients with contract hammer toes after calcaneal fractures were seen most often (n=26). Another large group of 24 patients suffered from the sequelae of a compartment and/or postischemic syndrome of the extrinsic muscles of the superficial and deeper compartment of the flexor tendons, producing a severe pes equino varus. Less common (n=16) were the deformities caused by an isolated compartment syndrome, such as necrosis of the anterior tibialis, long extensor muscles, peroneal muscles or a combined compartment syndrome of the lower leg and foot.

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

    Directory of Open Access Journals (Sweden)

    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 .

  17. Methicillin-resistant Staphylococcus aureus infected gluteal compartment syndrome with rhabdomyolysis in a bodybuilder.

    Science.gov (United States)

    Woon, Colin Yl; Patel, Kushal R; Goldberg, Benjamin A

    2016-05-18

    Gluteal compartment syndrome (GCS) is a rare condition. We present a case of gluteal muscle strain with hematoma formation, methicillin-resistant Staphylococcus aureus (MRSA) superinfection, leading to acute GCS, rhabdomyolysis and acute kidney injury. This combination of diagnoses has not been reported in the literature. A 36-year-old Caucasian male presented with buttock pain, swelling and fever after lifting weights. Gluteal compartment pressure was markedly elevated compared with the contralateral side. Investigations revealed elevated white blood cell, erythrocyte sedimentation rate, C-reactive protein, creatine kinase, creatinine and lactic acid. Urinalysis was consistent with myoglobinuria. Magnetic resonance imaging showed increased T2 signal in the gluteus maximus and a central hematoma. Cultures taken from the emergency debridement and fasciotomy revealed MRSA. He had repeat, debridement 2 d later, and delayed primary closure 3 d after. GCS is rare and must be suspected when patients present with pain and swelling after an inciting event. They are easily diagnosed with compartment pressure monitoring. The treatment of gluteal abscess and compartment syndrome is the same and involves rapid surgical debridement.

  18. Acute compartment syndrome of the hand in Henoch-Schonlein Purpura

    Directory of Open Access Journals (Sweden)

    Luis Guntur E

    2007-03-01

    Full Text Available Abstract An eight year old boy with Henoch-Schonlein Purpura (HSP presented with acute compartment syndrome (ACS of his left hand following arterial cannulation of his radial artery in intensive care unit. Emergency decompression and fasciotomy were performed. The authors report this first case in literature and discuss how HSP can be complicated by ACS and ways to prevent the latter from happening.

  19. Management of Complex Extremity Injuries: Tourniquets, Compartment Syndrome Detection, Fasciotomy, and Amputation Care

    Science.gov (United States)

    2012-01-01

    E mail address: robert.rush1@us.army.mil KEYWORDS Extremity injury Mangled extremity Amputation Compartment syndrome Fasciotomy Prosthesis ...definitive repair. For ray amputations of the foot , removing the big toe in most cases is worse than a transmetatarsal amputation due to lack of...from lack of total contact with the prosthesis and requires refitting. Heterotopic ossification (HO), the aberrant formation of mature, lamellar bone in

  20. [Compartment syndrome in bilateral lower legs after total cystectomy: a case report].

    Science.gov (United States)

    Sumiyoshi, Takayuki; Utsunomiya, Noriaki; Segawa, Takehiko; Muguruma, Koei; Ichikawa, Koichi; Kawakita, Mutsushi

    2011-02-01

    We report a case of compartment syndrome in bilateral lower legs after total cystectomy with urethrectomy and ileal conduit diversion. A 64-year-old man who had diabetes mellitus for 20 years underwent an operation for invasive bladder cancer. He was placed in the lithotomy position and both lower legs were protected with an elastic stocking and intermittent pneumatic compression for prevention of deep vein thrombosis during the operation. Seven hours postoperatively, he complained of bilateral calf pain. Eleven hours postoperatively, skin redness, swelling, movement and sensory disorder of bilateral lower legs were found. Contrasting computed tomography (CT) of lower legs showed the swelling of bilateral soleus muscles and gastrocnemius muscles without any contrasting effect. Creatinine phosphokinase (CPK) increased to 46, 740 IU/l and the intramuscular pressure was 50 mmHg. He was diagnosed with compartment syndrome, in bilateral lower legs and emergent fasciotomy was performed. Bilateral calf pain was improved immediately after fasciotomy and could walk on his own after rehabilitation. Lower leg compartment syndrome is an uncommon disease but may require lower leg amputation or result in death if the treatment is delayed. Urologists should recognize this disease as a complication after prolonged operation in the lithotomy position.

  1. Abdominal Decompression in Children

    Directory of Open Access Journals (Sweden)

    J. Chiaka Ejike

    2012-01-01

    Full Text Available Abdominal compartment syndrome (ACS increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH by intra-abdominal pressure (IAP monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children.

  2. [Intraabdominal hypertension syndrome in patients with abdominal sepsis].

    Science.gov (United States)

    Kryvoruchko, I A; Ivanova, Iu V; Povelichenko, M S; Andreieshchev, S A

    2014-05-01

    Investigations were conducted in 53 patients, operated on in 2013 yr for abdominal sepsis (AS). The patients state severity was determined in accordance to the systemic inflammatory reaction and the polyorgan insufficiency severity. In 28 patients (group I) AS was diagnosed, in 14 (group II)--severe AS, in 11 (group III)--a septic shock. Tactics of surgical management of the patients have included two main measures: the infection origin control (source control), and control of the affected organ function and systemic defense mechanisms (damage control). In all the patients in AS the intraabdominal pressure rising was revealed. Syndrome of intraabdominal hypertension was noted in 10 (18.9%) patients (in 4--while presence of severe AS, and in 6--in septic shock). Lethality was the highest in intraabdominal hypertension degrees III and IV (11 of 25 patients have died).

  3. Excision of a large abdominal wall lipoma improved bowel passage in a Proteus syndrome patient

    OpenAIRE

    2009-01-01

    Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth of tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progr...

  4. Multiple abdominal cysts in a patient with Gorlin-Goltz syndrome: a case report.

    Science.gov (United States)

    Haenen, F; Hubens, G; Creytens, D; Vaneerdeweg, W

    2013-01-01

    A rare case of symptomatic mesenteric cysts in a patient with Gorlin-Goltz syndrome, associated with various neoplasms, is presented. The patient, known with Gorlin-Goltz syndrome, consulted with increasingly severe abdominal pain and large abdominal cysts. At surgery, the cysts were excised and the postoperative course was uneventful. In conclusion, this case reminds clinicians to always maintain a wide differential diagnosis when dealing with patients known with Gorlin-Goltz syndrome.

  5. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

    Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels

    2016-01-01

    complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure......OBJECTIVE: To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. MATERIALS AND METHODS: Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh...

  6. Association Between Carpal Tunnel Syndrome and Abdominal Obesity

    Directory of Open Access Journals (Sweden)

    Ertuğrul Uzar

    2010-12-01

    Full Text Available OBJECTIVE: Obesity has been suggested as a risk factor for carpal tunnel syndrome (CTS. Previous studies on the association of CTS and obesity have generally considered body mass index (BMI. However, the relationships between CTS and waist circumference or waist-to-hip ratio (WHR, which are known as more sensitive measures for abdominal obesity, have not been studied previously. In this study, it was aimed to evaluate the role of BMI and abdominal obesity in patients with CTS. METHODS: Female patients who applied to the neurology outpatient clinics with pain, numbness, paresthesia, or dysesthesia in the hands were included. The patients were divided into two groups, according to the clinical evaluation, as CTS or non-CTS. CTS diagnosis was electrophysiologically confirmed in 44 patients. Thirty-one subjects who were not diagnosed as CTS electrophysiologically were recruited as the control group. Clinical findings, nerve conduction studies and anthropometric measurements (height, weight, BMI, hip circumference, waist circumference and WHR of CTS patients were compared with those of the control group. RESULTS: The CTS group had significantly higher BMI, waist circumference and WHR values compared to the control group (for each parameter, p< 0.0001. The rates of obesity in the CTS group were 55.8%, 47.7% and 34.9%, respectively, according to waist circumference, BMI and WHR measurements. In the CTS group, 16% of the patients, who were defined as non-obese according to BMI, were determined as obese according to waist circumference. In the CTS group, significant positive correlations were found between BMI and WHR and median-ulnar sensory interpeak latency of the fourth digit (r= 0.26, p< 0.05; r= 0.25, p< 0.05, respectively. CONCLUSION: In this study, it was found that abdominal obesity is an important risk factor for CTS, and nerve conduction may be affected by waist circumference, BMI and WHR. In addition to general obesity, abdominal obesity may

  7. Calf Compartment Syndrome associated with the Use of an Intra-osseous Line in an Adult Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Malhotra R

    2016-11-01

    Full Text Available We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement. Two incision fasciotomy on his left lower leg was performed. Intra osseous-lines in the proximal tibia are increasingly used in adult patients in the pre-hospital setting by paramedics and emergency physicians. Their use, along with the possible complications of these devices, such as the development of compartment syndrome or osteomyelitis leading to amputation, is well reported in the paediatric literature. To the best of our knowledge, there have not been any previous reports of complications in the adult patient. We present a case of lower leg compartment syndrome developing from the use of an intra-osseous line in the proximal tibia in an adult patient. With the increasing use of intra-osseous lines in adult patients, clinicians should be aware of the possibility of developing compartment syndrome which may lead to disability or amputation in severe cases.

  8. Lessons learned from a case of calf compartment syndrome after robot-assisted laparoscopic prostatectomy.

    Science.gov (United States)

    Rosevear, Henry M; Lightfoot, Andrew J; Zahs, Marta; Waxman, Steve W; Winfield, Howard N

    2010-10-01

    Robot-assisted laparoscopic prostatectomy is rapidly gaining favor as a minimally invasive method to surgically address prostate cancer. The sophisticated equipment and unique positioning requirements of this technology require exceptional preparation and attention to detail to minimize the chance of surgical complications. We present the case of a 57-year-old man who developed left calf compartment syndrome after (robot-assisted laparoscopic prostatectomy) requiring fasciotomies. We use this example to highlight specific areas of risk unique to the da Vinci Surgical System® using intraoperative photos to show danger areas as well as review basic positioning requirements common to all prolonged pelvic surgeries performed in Trendelenburg position.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. [Mutual role of factors of endotoxicosis and intra-abdominal hypertension syndrome in pathogenesis of abdominal sepsis].

    Science.gov (United States)

    Veliev, N A; Gasanova, D N; Ismailov, V F

    2013-10-01

    The mutual role of the main factors of endotoxicosis and intraabdominal hypertension syndrome (IHS) were studied in pathogenesis of abdominal sepsis, basing on analysis of the treatment results in 156 patients, suffering this disease. The contents of neutrophils, macrophages, interleukins (IL-6, IL-10) were studied in peritoneal exudate as the indices of the source of inflammation in abdominal cavity. There was established the mutual strengthening of the endotoxicosis and IHS factors, what causes the clinical signs of the organ dysfunction, determines the course severity and outcome of pathological process in the organism. Such approach to pathogenesis of abdominal sepsis permits in time and adequately to elaborate the certain program of treatment in the patients.

  11. Lower limb compartment syndrome by reperfusion injury after treatment of arterial thrombosis post-laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer

    Science.gov (United States)

    Yeon, Jihee; Jung, Ye Won; Yang, Shin Seok; Kang, Byung Hun; Lee, Mina; Ko, Young Bok; Yang, Jung Bo; Lee, Ki Hwan

    2017-01-01

    Compartment syndrome is a clinical condition associated with decreased blood circulation that can lead to swelling of tissue in limited space. Several factors including lithotomy position, prolonged surgery, intermittent pneumatic compressor, and reperfusion after treatment of arterial thrombosis may contribute to compartment syndrome. However, compartment syndrome rarely occurs after gynecologic surgery. In this case, the patient was diagnosed as compartment syndrome due to reperfusion injury after treatment of arterial thrombosis, which occurred after laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer. Despite its rarity, prevention and identifying the risk factors of complication should be performed perioperatively; furthermore, gynecologist should be aware of the possibility of complications. PMID:28344966

  12. Angiograms of the Abdominal Aorta in a Patient of Middle Aortic Syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhou Yafeng; Yang Xiangjun; Song Jianping; Jiang Tingbo; Li Xun; Hui Jie; Liu Zhihua; Jiang Wenping

    2007-01-01

    A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aorta, and extensively enlarged collateral vascular supply to the lower portion of abdominal aorta. The pressures proximal and distal to stenosis were 185/110 and 95/70 mmHg, and the pressure gradient across the stenosis was 90/40 mmHg. After the operation of thoraco-abdominal bypass graft, the pressure difference between the upper and lower extremities eventually disappeared.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Lower extremity compartment syndrome in the acute care surgery paradigm: safety lessons learned

    Directory of Open Access Journals (Sweden)

    Cothren Clay C

    2009-06-01

    Full Text Available Abstract Background Prompt diagnosis and decompression of acute lower extremity compartment syndrome (LECS in the multisystem injured patient is essential to avoid the devastating complications of progressive tissue necrosis and amputation. Despite collaborative trauma and orthopedic management of these difficult cases, significant delays in diagnosis and treatment occur. Periodic system review of our trauma and orthopedic data for complications of LECS led us to hypothesize that delayed diagnosis and limb loss were potentially preventable events in our trauma center. Setting Academic level 1 trauma center. Methods We performed a prospective review of our trauma registry for all cases of LECS over a 7 year period (2/98–10/2005. Variables reviewed included demographics, injury patterns, tissue necrosis, amputation and mortality. Results Eighty-three (10 female, 73 male cases were reviewed. Mean age = 33.3 years (range 1–78. Mean ISS = 19.4, GCS = 12.5. Five (6.0% had amputations; 7 (8.4% died. Fractures occurred in 68.7% (n = 57, and vascular injuries were present in 38.6% (n = 32. In 7 patients (8.4%, a delayed compartment release resulted in muscle necrosis requiring multiple debridements, subsequent wound closure problems, and long term disability. Of note, none of these patients had prior compartment pressure measurements. Furthermore, 6 patients (7% had superficial peroneal nerve transections as complications of their fasciotomy. Conclusion In the multisystem injured patient, LECS remains a major diagnostic and treatment challenge with significant risks of limb loss as well as complications from decompressive fasciotomy. These data underscore the importance of routine surveillance for LECS. In addition, a thorough knowledge of regional anatomy is essential to avoid technical morbidity.

  15. Testicular compartment syndrome: an overview of pathophysiology, etiology, evaluation, and management

    Science.gov (United States)

    Gandhi, Jason; Dagur, Gautam; Sheynkin, Yefim R.; Smith, Noel L.

    2016-01-01

    Testicular compartment syndrome (TCS) refers to the impairment of microcirculation in the testicle due to either increased venous resistance or extraluminal compression, which leads to hypoxia. TCS releases oxidants through hypoxia and ischemia/reperfusion injury (IRI). The pathophysiology, etiology, evaluation, and management of TCS are reviewed. Based on the properties of TCS, specific causes, e.g., varicocele, hydrocele, orchitis, cryptorchidism, and scrotal hernia, are suggested and categorized. The oxidant-induced stress from TCS may explain the correlations between these causes and infertility. A chief shortcoming of current imaging modalities is that they detect TCS late after it has progressed to impair the macrocirculation of the testicle. We propose frequent sequential periodic power Doppler ultrasonography to monitoring for earlier detection. Intraoperatively, TCS can be diagnosed by the dull purple appearance of a hypoxic testicle and by tissue pressures above 30 mmHg. When compartment pressure is low, the underlying etiology must be promptly treated. During acute presentation, an incision of the resilient tunica albuginea may be necessary. A great challenge of treating TCS is restoring microcirculation while minimizing IRI; concomitant antioxidant therapy secondary to treatment may be effective and harmless at the least. Because testicular oxidant stress is common in infertility and since TCS can cause such a stress, TCS may be a larger factor in infertility than currently suspected. PMID:28078225

  16. Delayed onset of acute limb compartment syndrome with neuropathy after venoarterial extracorporeal membrane oxygenation therapy.

    Science.gov (United States)

    Go, Jin Young; Min, Yu-Sun; Jung, Tae-Du

    2014-08-01

    Acute limb compartment syndrome (ALCS) is defined as compound symptoms resulting from poor oxygenation and decreased nutrition supply to muscles and nerves in a tightly confined compartment. The most common cause of ALCS is tibia fracture, followed by blunt trauma to soft tissue. However, non-traumatic causes are rare. We report an iatrogenic, non-traumatic ALCS case after venoarterial extracorporeal membrane oxygen (VA-ECMO) therapy. A 14-year-old male received VA-ECMO therapy due to cardiorespiratory failure after drowning. Although he had no symptoms during therapy, leg swelling appeared 10 hours after ECMO treatment. Two days after the leg swelling, the patient underwent a fasciotomy. Unfortunately, nerve conduction studies and electromyography showed multiple neuropathies in the lower leg. Despite 2 weeks of rehabilitation with electrical stimulation, an exercise program, and physical therapy, there was no definite change in muscle strength. To our knowledge, this is the first reported case of non-traumatic ALCS after VA-ECMO therapy in Korea.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Bilateral gluteal compartment syndrome and severe rhabdomyolysis after lumbar spine surgery.

    Science.gov (United States)

    Rudolph, Thomas; Løkebø, Jan Eirik; Andreassen, Lasse

    2011-07-01

    Gluteal compartment syndrome (GCS) is an extremely rare and potentially devasting disorder, most commonly caused by gluteal muscle compression in extend periods of immobilization. We report a 65-year-old obese man with hypertension, diabetes mellitus type 2 and hypercholesterolemia underwent lumbar spine surgery in knee-chest position because of degenerative lumbar stenosis. Perioperative hypotension occurred. After surgery, the patient developed increasing pain in the buttocks of both sides and oliguria with darkened urine. Stiffness, tenderness and painful swelling of patients gluteal muscles of both sides, high creatine phosphokinase level, myoglobulinuria and oliguria led to diagnosis of bilateral GCS, complicated by severe rhabdomyolysis (RM) and acute renal failure. In conclusion, obese patients with vascular risk factors and perioperative hypotension may be at risk for developing bilateral GCS and RM when performing prolonged lumbar spine surgery. Early diagnosis and treatment is important, as otherwise, the further course may be fatal.

  19. Compartment syndrome of forearm and hand as complication of prone position during neurosurgery operation

    Directory of Open Access Journals (Sweden)

    Dusica Stamenkovic

    2012-06-01

    Full Text Available We present a case of compartment syndrome (CS after neurosurgical operation where patient was 6 hours in prone position with forearm and hand beneath his chest. Clinical signs were confirmed with measuring of intra-compartmal pressure (ICP, and fasciotomy of forearm and hand were performed. After 3 months of rehabilitation all movements and strength in hand and fingers were come back. CS is a rare complication, but if unrecognized and untreated it can seriously damage extremities. Measuring of ICP is a simple and reliable diagnostic procedure in unclear cases and prompt fasciotomy is a salvage procedure with good results. [J Exp Integr Med 2012; 2(3.000: 277-279

  20. 骨筋膜室综合征的护理%Care of Compartment Syndrome

    Institute of Scientific and Technical Information of China (English)

    柯贵伟

    2014-01-01

    通过对骨筋膜室综合征的病因及临床表现而采取的相应的治疗及护理体会。加强基础护理,正确指导患者功能锻练,积极进行健康教育,积极预防并发症,才能促进患者早日愈合。%the experience of treatment and nursing of corresponding to the etiology and clinical manifestations of compartment syndrome. Strengthening basic nursing, correct guidance function in patients with positive exercise, health education, prevention of complications, to improve patient's healing.

  1. Excision of a large abdominal wall lipoma improved bowel passage in a Proteus syndrome patient.

    Science.gov (United States)

    Nakayama, Yoshifumi; Kusuda, Shinichi; Nagata, Naoki; Yamaguchi, Koji

    2009-07-14

    Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth of tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progressive constipation, nausea, vomiting, and abdominal pain. Computed tomography (CT) of the abdomen demonstrated a large mass in the subcutaneous adipose tissue of the left lower abdominal wall which measured 12 cm x 8 cm x 6 cm in diameter and encased the left colon. This mass in the abdominal wall was excised. The weight of the excised mass was 1550 g. The histopathological diagnosis of this mass was lipoma. After surgery, the encasement of the left colon was improved, and the patient was able to move her bowels twice per day. The excision of the large lipoma in the abdominal wall contributed to the improved bowel passage in this patient with Proteus syndrome.

  2. Salter-Harris II injury of the proximal tibial epiphysis with both vascular compromise and compartment syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Clement Nicholas D

    2009-06-01

    Full Text Available Abstract We present a case of a Salter-Harris II injury to the proximal tibia associated with both vascular compromise and compartment syndrome. The potential complications of this injury are limb threatening and the neurovasular status of the limb should be continually monitored. Maintaining anatomic reduction is difficult and fixation may be needed to achieve optimal results.

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

    NARCIS (Netherlands)

    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

  4. McKusick-Kaufman syndrome: the diagnostic challenge of abdominal distension in the neonatal period.

    Science.gov (United States)

    Schaap, C; de Die-Smulders, C E; Kuijten, R H; Fryns, J P

    1992-08-01

    We report a newborn girl with McKusick-Kaufman syndrome who presented at birth with severe life-threatening abdominal distension due to hydrometrocolpos. In children with polydactyly and cystic masses in the lower abdomen should hydrometrocolpos be especially considered. Ultrasonography is of great value in the correct assignment of lower abdominal tumours, but should be completed by vagino(cysto)scopy when hydrometrocolpos is suspected.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Excision of a large abdominal wall lipoma improved bowel passage in a Proteus syndrome patient

    Institute of Scientific and Technical Information of China (English)

    Yoshifumi Nakayama; Shinichi Kusuda; Naoki Nagata; Koji Yamaguchi

    2009-01-01

    Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progressive constipation,nausea, vomiting, and abdominal pain. Computed tomography (CT) of the abdomen demonstrated large mass in the subcutaneous adipose tissue of the cm x 6 cm in diameter and encased the left colon. This mass in the abdominal wall was excised. The weight of the excised mass was 1550 g. The histopathological diagnosis of this mass was lipoma. After surgery, the encasement of the left colon was improved, and the patient was able to move her bowels twice per day. The excision of the large lipoma in the abdominal wall contributed to the improved bowel passage in this patient with Proteus syndrome.

  7. Abdominal compartment syndrome and open abdomen management with negative pressure devices.

    Science.gov (United States)

    Surace, Alessandra; Ferrarese, Alessia; Marola, Silvia; Cumbo, Jacopo; Valentina, Gentile; Borello, Alessandro; Solej, Mario; Martino, Valter; Nano, Mario

    2015-01-01

    Per sindrome compartimentale addominale (SCA) si intende un incremento della pressione intra-addominale (PIA) a valori superiori a 20 mmHg, associato ad una ridotta perfusione e disfunzione d’organo. La mortalità della SCA è del 50%; la sua incidenza tra i pazienti in RIA è del 30-50%. Il trattamento chirurgico consiste sostanzialmente nella decompressione addominale con apertura dell’addome; attualmente la metodica più utilizzata per la gestione della SCA è la terapia a pressione negativa. Nel 2009 è stata realizzata una classificazione dell’addome aperto, che stratifica i pazienti in base alla cronologia naturale del miglioramento o del deterioramento clinico dei pazienti con addome aperto. Lo scopo del trattamento è mantenere l’addome aperto del paziente al livello più basso ed evitare la progressione ad un livello più complesso. Secondo quanto riportato in letteratura questa metodica consente un tasso di chiusura fasciale tra i 65 e il 100% dei casi, riduce i tassi di mortalità e i tempi di degenza nei reparti di terapia intensiva. La chiusura dell’addome può avvenire progressivamente (per ridurre il rischio di fascite) oppure mediante l’utilizzo di una protesi biologia spessa su cui viene posizionata una copertura in plastica e impostato il lavaggio nel sottocute: la parete addominale deve essere chiusa dopo 24 ore. Se non fosse possibile chiudere tutti gli strati della parete addominale, il tentativo deve riguardare almeno il peritoneo, per ridurre morbilità e mortalità.

  8. [Open treatment of abdominal compartment syndrome after contained aortic aneurysm rupture].

    Science.gov (United States)

    Mihály, Zsuzsanna; Perczel, Kristóf; Csikós, Gergely; Szeberin, Zoltán

    2014-10-01

    Magyarországon elsőként közöljük esetünket, amelyben sikerrel alkalmaztunk nyitott hasi és VAC- (vákuumasszisztált sebzárás) kezelést aortaaneurysma-ruptura miatt kialakuló hasi compartmentsyndroma megelőzéseként. Esetismertetés: Az 59 éves nőbeteg acutan került felvételre klinikánkra, akinél az angio-CT-vizsgálat fedett hasi aortaaneurysma-rupturát igazolt. Az acut laparotomiából végzett aortoaorticus Dacron graft interpositióját követően, a has zárásakor a beteg lélegeztethetetlenné vált a vékony- és vastagbél hosszú szakaszát érintő oedemája és a retroperitonealis vérgyülem okozta megemelkedett hasűri nyomás miatt. Ezért nyitott hasi kezelés és VAC-terápia mellett döntöttünk. Az ismételt kötéscseréket követően a has halasztott zárása DualMesh hálóval történt, három héttel később a beteg otthonába távozott. Megbeszélés: Esetünkben a nagyfokú oedema és a retroperitonealis haematoma miatt a fedett hasi aortaaneurysma-ruptura műtéti megoldását követően a has zárása már nem volt kivitelezhető. Az intraabdominalis nyomásfokozódás szövődményei megakadályozhatók voltak a nyitott hasi kezelésnek köszönhetően. Esetünk tapasztalata és a szakirodalom ajánlása alapján javasoljuk a nyitott hasi kezelést VAC-rendszerrel kombinálva hasi compartmentsyndroma esetén.

  9. Medical image of the week: abdominal compartment syndrome due to massive upper gastrointestinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Truong VN

    2014-11-01

    Full Text Available No abstract available. Article truncated after 150 words. A 29 year old woman with history of a Whipple procedure for pancreatic cancer and nonalcoholic steatohepatitis cirrhosis presented with a massive upper gastrointestinal bleeding (UGIB likely from esophageal varices and developed hemorrhagic shock. Emergent upper endoscopy could not be performed due to hemodynamic instability. Therefore, a Minnesota Tube was placed emergently for balloon tamponade of the bleeding. A transjugular intrahepatic portosystemic shunt was also placed emergently to decrease bleeding by reducing portal pressure. By this time, the patient had received 4 liters of normal saline, 14 units of packed red blood cells, 6 units of platelets, and 4 units of fresh frozen plasma. The Minnesota tube did control the bleeding somewhat, however, there was continued bloody drainage from the stomach port of the Minnesota tube. The patient’s abdomen became remarkably distended and was dull to percussion throughout. A CT scan of the abdomen and pelvis revealed severe dilatation of ...

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

    Institute of Scientific and Technical Information of China (English)

    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. Recurrent abdominal pain and irritable bowel syndrome in children

    Science.gov (United States)

    Recurrent abdominal pain continues to be one of the most ubiquitous conditions faced by the healthcare team, and has a significant emotional and economic impact. We have moved from considering it a psychological condition to recognizing the physiological and environmental contributions, and consider...

  12. Abdominal aortic thrombosis in a patient with nephrotic syndrome.

    Science.gov (United States)

    Nakamura, M; Ohnishi, T; Okamoto, S; Yamakado, T; Isaka, N; Nakano, T

    1998-01-01

    We report a patient who presented with severe nephrotic syndrome complicated with infrarenal aortic and right renal arterial thrombosis. The nephrotic syndrome frequently causes thromboembolic complications in veins, but arterial thrombosis is relatively rare, especially in the aorta. Various predisposing factors leading to thromboembolic complications are discussed. In this case, the thromboembolic complication may have some clinical association with the hypercoagulable state in nephrotic syndrome.

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

    LENUS (Irish Health Repository)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    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.

  16. [Compartment syndrome in pathogenesis of lower limb exertional disease in servicemen].

    Science.gov (United States)

    Savka, I S; Boĭko, S A

    2002-01-01

    As many as 35 servicemen presenting with a pathological reorganization and stress fractures of shin bones and foot were examined. A measurement of the subfascial pressure was done together with a study of pulse propagation along the tibial and fibial nerves and of bioelectrical activity of foot muscles innervated by the above nerves. The subfascial pressure in the anterior and posterior deep sheaths of the shin appeared to be increased in rest, especially so in the wake of physical loads on the affected extremity even if the process was localized in the foot. The velocity of the pulse propagation along the nerves was found to be decreased, the latent period increased, amplitude decreased, the duration of M-response longer in the affected extremity, with a 38 to 47% decrease in the frequency and amplitude of biological activity of maximum muscular contraction having been recordable. The latter observation has corroborated our assumption that in weight-bearing disease of the extremities there would be present a chronic compartment-syndrome which is of reccurrent character, causes disturbances in the neuromuscular apparatus of the extremity (ischemic demyelinization of the nerve fibers and dystrophic changes in the muscles innervated by the above nerve fibers), which fact may lead to recurrences of weight-bearing disease, prolonged treatment and restoration of the function.

  17. Chronic exertional compartment syndrome of the forearm in motocross racers: findings on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Gielen, Jan Louis [Antwerp University Hospital, Department of Radiology, Antwerp (Belgium); Antwerp University Hospital, Multidisciplinary Department of Sports Medicine, Antwerp (Belgium); Peersman, Benjamin; Dyck, Pieter van; Vanhoenacker, Filip [Antwerp University Hospital, Department of Radiology, Antwerp (Belgium); Peersman, Geert [ZNA, Department of Orthopaedic Surgery, Antwerp (Belgium); Roelant, Ella [Antwerp University Hospital, Department of Scientific Coordination, Antwerp (Belgium); Roeykens, Johan [Antwerp University Hospital, Multidisciplinary Department of Sports Medicine, Antwerp (Belgium)

    2009-12-15

    The purpose of this prospective study was to demonstrate the findings of MRI in motocross racers with chronic exertional compartment syndrome (CECS) of the forearm. Racers with proven CECS and without CECS and male individuals not involved in strenuous activities with the forearm were included. Signal intensity (SI) and signal-to-noise ratio (SNR) obtained before and after exercise were compared (D-SNR). Magnetic resonance imaging after exercise showed an increase in SI and SNR in the muscles on T2-WI. The SI increase was obvious in the flexor digitorum superficialis (FDS) and profundus (FDP) in all CECS patients. In addition, a minor SI and SNR increase in the extensor carpi radialis longus (ECRL) was noted. In the non-symptomatic group of motocross racers, there was only a minor increase in SI and the SNR, which was similar in the FDP and ECRL muscles. In the untrained individuals a remarkable increase in the SI and SNR of the FDS/FDP-ECRL was noted. This increased SI and SNR was not present in the majority of non-symptomatic racers. Post-exertional MRI produces significant findings in CECS of the forearm. The motocross racers without post-exertional oedema in the FDP/FDS had no CECS. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Increased gastrointestinal permeability and gut inflammation in children with functional abdominal pain and Irritable Bowel Syndrome

    Science.gov (United States)

    To determine gastrointestinal (GI) permeability and fecal calprotectin concentration in children 7 to 10 years of age with functional abdominal pain and irritable bowel syndrome (FAP/IBS) versus control subjects and ascertain potential relationships with pain symptoms and stooling, GI permeability a...

  20. Autonomic nervous system function in young children with functional abdominal pain or irritable bowel syndrome

    Science.gov (United States)

    Adults with irritable bowel syndrome (IBS) have been reported to have alterations in autonomic nervous system function as measured by vagal activity via heart rate variability. Whether the same is true for children is unknown. We compared young children 7 to 10 years of age with functional abdominal...

  1. Ischemic jejunal stenosis and blind loop syndrome after blunt abdominal trauma.

    Science.gov (United States)

    Isaacs, P; Rendall, M; Hoskins, E O; Missen, G A; Sladen, G E

    1987-02-01

    One month after suffering blunt abdominal trauma a patient developed severe steatorrhea and profound weight loss in association with an ischemic distal jejunal stricture and blind loop syndrome. Evidence for a partial mesenteric tear was found at resection of the stricture, which resulted in complete cure.

  2. Computed tomography angiography and magnetic resonance imaging performance of acute segmental single compartment syndrome following an Achilles tendon repair: A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Li-Feng Jiang; Hang Li; Zeng-Feng Xin; Li-Dong Wu

    2016-01-01

    Acute compartment syndrome of the lower extremity is a serious postinjury complication that requires emergency treatment.Early diagnosis is of paramount importance for a good outcome.Four muscle compartments in the calf (anterior,lateral,deep posterior,and superficial posterior) may be individually or collectively affected.Acute segmental single-compartment syndrome is an extremely rare condition characterized by high pressure in a single compartment space with threatening of the segmental tissue viability.In this case report,we describe a young man with Achilles tendon rupture who complained of postoperative pain in the anterior tibial region.Emergent computed tomography angiography and magnetic resonance imaging revealed local muscle edema.Segmental anterior compartment syndrome was diagnosed and fasciotomy was performed.

  3. 腰骶部骨筋膜室综合征%The osteofascial compartment syndrome of the lumbosacral region

    Institute of Scientific and Technical Information of China (English)

    谢洪峰; 郭桂英; 王宝稷; 杜心如; 刘宝勋

    2001-01-01

    目的:探讨腰骶部骨筋膜室综合征与慢性腰痛的关系。方法:对27例腰骶部骨筋膜室综合征患者临床的诊断及治疗。结果:以脱水为主的早期综合治疗,可以明显缓解腰骶部骨筋膜室综合征的疼痛,减少腰肌劳损发病率。结论:对腰骶部骨筋膜室综合征的认识及早期治疗,对预防或减少慢性腰肌劳损所致的慢性腰痛具有重要意义。%Objective: To study the relationship between low back and the osteofascial compartment syndrome of the lumbosacral region. Methods: We diagnosed and treated 27 cases of the osteofasciaI compartment syndrome of the lumbosacral region. Result: There patients who were treated with mannitol and rest have rapidly released their pain and the other symptoms. Conclusion: To early prevent this compartment syndrome can reduce the low back pain.

  4. 筋膜间隙综合征的诊断与治疗%Diagnosis and treatment of compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    田克; 郑重; 朱刚

    2008-01-01

    Objective To study the influence of early diagnosis and treatment of compartment syndrome on limbs. Methods Observation and treatment for early clinical symptom, including help the patient to lie stretched out, application of mannitol and operation for decompression, were practiced on 26 cases of patients with compartment syndrome on different sites. Results Of the 26 cases, except 1 case who had cut later more than 48 hours, the other cases all had good recovery. Conclusion Early diagnosis and decompression are necessary for treatment of compartment syndrome.%目的 探讨筋膜间隙综合征的早期诊断和治疗对四肢骨折治疗的影响.方法 对26例四肢骨折合并筋膜间隙综合征的病例进行早期观察和治疗,治疗方法包括肢体平放、应用甘露醇脱水、手术切开减压.结果 除1例切开时间较晚发生手部畸形外,其余均痊愈.结论 早期诊断和切开是治疗筋膜间隙综合征的关键.

  5. Conservative management of eosinophilic enteritis presenting with acute abdominal syndrome

    Directory of Open Access Journals (Sweden)

    Marco Bassi

    2013-04-01

    Full Text Available Eosinophilic enteritis, an increasing recognized condition, is rare and often presents with non-specific symptoms. We report a case of a 46-year old female who presented with acute onset abdominal pain and nausea associated with ascites, small bowel thickening and peripheral eosinophilia. Diagnosis was confirmed by biopsies taken at esophagogastroduodenoscopy demonstrating diffuse infiltration by inflammatory cells, mainly eosinophils. Appropriate therapy was instituted. The patient recovered well and was symptom-free at 1-month follow up. In this report, we discuss the clinical presentation and the diagnostic criteria of the eosinophilic enteritis, and examine the pathophysiological theories and therapeutic strategies. The relevant literature on eosinophilic enteritis is summarized.

  6. Meig’s Syndrome:A Triad of Pleural Effusion, Abdominal Ascites, and Benign Ovarian Fibroma

    Institute of Scientific and Technical Information of China (English)

    Yaseen Ali; Amila M. Parekh; Rahul K. Rao; Taseen Ali; Linda S. Schneider; Jordan Garvey; Mirza R. Baig

    2015-01-01

    Background:Meig’s syndrome is a rare syndrome characterized by a triad of recurrent pleural effusions, ascites, and the finding of a benign ovarian fibroma on diagnostic imaging and histopathological evaluation. Patients can present with any of the constellation of symptoms attributing to the disease state. With pleural effusions they can present with shortness of breath, chest pressure, dyspnea on exertion; symptoms that can be confused with the exacerbation of congestive heart failure. Ascites can present with abdominal tenseness, pain, bloating, cramping, constipation, and elevated liver enzymes. The ifnding of a benign ovarian ifbroma is found only during diagnostic imaging and histopathological evaluation. Case report:The patients was an 85-year-old female with a recent history of coronary artery bypass graft surgery for her severe coronary artery disease presented with the chief complaint of generalized malaise, abdominal pain, constipation of few days. She was initially scheduled to have her second therapeutic thoracentesis for her recurrent pleural effusion as an outpatient procedure but complained of the former symptoms and was admitted for observation and treatment of her abdominal symptoms. Her recurrent pleural effusions were initially attributed to the complications of her coronary artery bypass graft surgery for her severe coronary artery disease. During the admission and evaluation she was diagnosed with Meig’s syndrome. She underwent a left oophorectomy with total abdominal hysterectomy that led to the resolution of all her symptoms. Conclusion:Meig’s syndrome is a rare syndrome characterized by the triad of recurrent pleural effusions, ascites, and the ifnding of a benign ovarian ifbroma. The diagnosis and knowledge of this syndrome holds the key to its treatment. The treatment generally involves the resection of the ovarian ifbroma. After the resection of the ovarian ifbroma patients recover from the inconvenient pleural effusions and

  7. [Intra-Abdominal Germ Cell Tumor in Persistent Mullerian Duct Syndrome].

    Science.gov (United States)

    Mishima, Takao; Harada, Jiro; Kawa, Gen; Sakurai, Takanori; Okada, Takuya

    2016-08-01

    A 46-year-old man was admitted to hospital presenting with a lower abdominal mass. The patient's testes were not palpable in the scrotum, and the levels of lactic dehydrogenase, α-fetoprotein and human chorionic gonadotropin were all elevated. Enhanced computed tomography revealed that the lumen of the mass had penetrated the prostate. Pathological analysis of biopsy tissue indicated that the mass was a seminoma. Residual tumor resection was performed after chemotherapy. On histological examination, the lumen proved to be a Mullerian structure. Our diagnosis was an intra-abdominal germ cell tumor and persistent Mullerian duct syndrome.

  8. A Case of Nonisland Pedicled Foot Fillet Flap for Below-Knee Amputation Stump Wound: Treatment Option for Compartment Syndrome after Fibular Free Flap Surgery

    OpenAIRE

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-01-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was ...

  9. Value of abdominal angiography in Turner's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. A Single-Lumen Central Venous Catheter for Continuous and Direct Intra-abdominal Pressure Measurement

    NARCIS (Netherlands)

    O.J.F. van Waes (Oscar); J.B. Jaquet (Jean); W.C.J. Hop (Wim); M.J.M. Morak (Marjolein); J.N.M. IJzermans (Jan); J. Koning (Jan)

    2009-01-01

    textabstractBackground: Abdominal compartment syndrome (ACS) is associated with high morbidity and mortality rates. Therefore, the need for a good diagnostic tool to predict intra-abdominal hypertension (IAH) and progression to ACS is paramount. Bladder pressure (BP) has been used for several years

  13. A systematic review on intra-abdominal pressure in severely burned patients

    NARCIS (Netherlands)

    K.D. Strang; E.M.M. van Lieshout (Esther); R.S. Breederveld (Roelf S.); O.J.F. van Waes (Oscar)

    2014-01-01

    textabstractObjective Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are complications that may occur in severely burned patients. Evidenced based medicine for these patients is in its early development. The aim of this study was to provide an overview of literature rega

  14. Hypertriglyceridemia is a practical biomarker of metabolic syndrome in individuals with abdominal obesity.

    Science.gov (United States)

    Li, Zhaoping; Deng, Max L; Tseng, Chi-Hong; Heber, David

    2013-04-01

    Individuals with the metabolic syndrome have a significantly higher risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Body mass index (BMI) and waist circumference are inaccurate methods for assessing abdominal obesity; in addition, some obese individuals are metabolically healthy while some normal weight individuals have metabolic syndrome. The methods used to visualize intra-abdominal fat, such as computed tomography (CT) scan and magnetic resonance imaging (MRI), are not available to primary care practitioners as screening methods for the primary care patient. The present study examined commonly used biomarkers to assess which of them would be most predictive of metabolic syndrome to assess the feasibility of using indicators other than BMI in the assessment of obesity-associated disease risk in the primary care setting. We examined 169 (118 females, 51 males) obese individuals with increased waist circumference (>102 cm for men and >85 cm for women), who were patients at the UCLA Risk Factor Obesity Clinic. Of these, 59 had three or more criteria associated with metabolic syndrome. In a multivariate linear regression model including body weight, BMI, waist circumference, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, glucose, high-density lipoprotein, and triglycerides (TG), only log TG and glucose values were significantly associated with the presence of metabolic syndrome (pmetabolic syndrome and is a likely predictor for insulin resistance in individuals with increased waist circumference. This finding has significant implications for screening obese and normal weight individuals in the general population for clinically significant metabolic syndrome and prediabetes, which has a major public health impact given the common occurrence of metabolic syndrome and the need for early intervention to prevent T2DM.

  15. A Single-Incision Fasciotomy for Compartment Syndrome of the Lower Leg.

    Science.gov (United States)

    Ebraheim, Nabil A; Siddiqui, Saaid; Raberding, Craig

    2016-07-01

    Lower leg fasciotomy may be performed with a single lateral incision with or without fibulectomy, or by a double incision technique, with most surgeons preferring the later. The aim of this article is to describe a variation of an existing single-incision technique that will allow for the release of all four compartments with 1 incision. Our approach uses a paratibial route to release the deep posterior compartment (DPC) rather than a transfibular or parafibular route that has already been discussed in the literature. We approach the DPC from the anterior compartment, whereas the parafibular approach uses the posterior aspect of the fibula to reach the DPC. This affords a faster fasciotomy with a smaller flap, avoids potential damage to neurovascular bundle and among other advantages, makes its especially pragmatic for bedside fasciotomy, without the risk of injury to the peroneal nerves, which is common with dissection at the posterior aspect of the fibula.

  16. Surgical and anatomical studies on De Quervain's tenosynovitis syndrome: Variations in the first extensor compartment

    Directory of Open Access Journals (Sweden)

    Paulo Randal Pires J and uacute;nior

    2016-08-01

    Clinical relevance: As septation of the first extensor compartment and multiple APL tendons appears to represent risk factors for the development of DQT, prior knowledge of the frequency of such anomalies may assist surgeons in pre-operative evaluation and perioperative procedures. [Hand Microsurg 2016; 5(2.000: 50-55

  17. Mega aorta syndrome: a case of thoracic and abdominal aortic aneurysm.

    Science.gov (United States)

    Wu, William C; Mitchell, Christopher A; Linklater, Derek

    2010-07-01

    An 83-year-old woman presented to the emergency department (ED) via emergency medical services with the chief complaint of "strokelike symptoms." Physical examination revealed altered mental status, tachycardia, hypotension, and a large nonpulsatile periumbilical mass. Bedside ultrasound revealed a 9-cm abdominal aortic aneurysm with absent central flow. Computed tomography scan demonstrated diffuse thoracic and abdominal aortic dilation with rupture into the mediastinum along with left hemothorax. Repeat beside ultrasound demonstrated abdominal aortic aneurysm rupture not seen on the computed tomography scan. Despite aggressive resuscitation, the patient developed bradycardia, which devolved into pulseless electric activity cardiac arrest. She was unable to be resuscitated. The patient's diffuse aneurysmal dilation places her into the small category of patients with a disease entity known as mega aorta syndrome (MAS). Mega aorta syndrome is defined as aneurysmal dilation of the aorta to greater than 6 cm in diameter. Although not in our case, most cases of MAS are symptomatic before catastrophic presentation. The disease progression for these patients is slow and occurs over years. When this disease is recognized early, a surgery known as the elephant trunk procedure can be performed. This operation replaces the entire aorta in multiple stages. This gives the emergency physician a critical role in the diagnosis and outcome of these patients because they may come through the ED for an unrelated complaint early in the disease process. This case report illustrates an advanced case of MAS.

  18. The proliferation index of specific bone marrow cell compartments from myelodysplastic syndromes is associated with the diagnostic and patient outcome.

    Directory of Open Access Journals (Sweden)

    Sergio Matarraz

    Full Text Available Myelodysplastic syndromes (MDS are clonal stem cell disorders which frequently show a hypercellular dysplastic bone marrow (BM associated with inefficient hematopoiesis and peripheral cytopenias due to increased apoptosis and maturation blockades. Currently, little is known about the role of cell proliferation in compensating for the BM failure syndrome and in determining patient outcome. Here, we analyzed the proliferation index (PI of different compartments of BM hematopoietic cells in 106 MDS patients compared to both normal/reactive BM (n = 94 and acute myeloid leukemia (AML; n = 30 cases using multiparameter flow cytometry. Our results show abnormally increased overall BM proliferation profiles in MDS which significantly differ between early/low-risk and advanced/high-risk cases. Early/low-risk patients showed increased proliferation of non-lymphoid CD34(+ precursors, maturing neutrophils and nucleated red blood cells (NRBC, while the PI of these compartments of BM precursors progressively fell below normal values towards AML levels in advanced/high-risk MDS. Decreased proliferation of non-lymphoid CD34(+ and NRBC precursors was significantly associated with adverse disease features, shorter overall survival (OS and transformation to AML, both in the whole series and when low- and high-risk MDS patients were separately considered, the PI of NRBC emerging as the most powerful independent predictor for OS and progression to AML. In conclusion, assessment of the PI of NRBC, and potentially also of other compartments of BM precursors (e.g.: myeloid CD34(+ HPC, could significantly contribute to a better management of MDS.

  19. The Proliferation Index of Specific Bone Marrow Cell Compartments from Myelodysplastic Syndromes Is Associated with the Diagnostic and Patient Outcome

    Science.gov (United States)

    Matarraz, Sergio; Teodosio, Cristina; Fernandez, Carlos; Albors, Manuel; Jara-Acevedo, María; López, Antonio; Gonzalez-Gonzalez, María; Gutierrez, María Laura; Flores-Montero, Juan; Cerveró, Carlos; Pizarro-Perea, Marlies; Garrastazul, María Paz; Caballero, Gonzalo; Gutierrez, Oliver; Mendez, Guy Daniel; González-Silva, Manuel; Laranjeira, Paula; Orfao, Alberto

    2012-01-01

    Myelodysplastic syndromes (MDS) are clonal stem cell disorders which frequently show a hypercellular dysplastic bone marrow (BM) associated with inefficient hematopoiesis and peripheral cytopenias due to increased apoptosis and maturation blockades. Currently, little is known about the role of cell proliferation in compensating for the BM failure syndrome and in determining patient outcome. Here, we analyzed the proliferation index (PI) of different compartments of BM hematopoietic cells in 106 MDS patients compared to both normal/reactive BM (n = 94) and acute myeloid leukemia (AML; n = 30 cases) using multiparameter flow cytometry. Our results show abnormally increased overall BM proliferation profiles in MDS which significantly differ between early/low-risk and advanced/high-risk cases. Early/low-risk patients showed increased proliferation of non-lymphoid CD34+ precursors, maturing neutrophils and nucleated red blood cells (NRBC), while the PI of these compartments of BM precursors progressively fell below normal values towards AML levels in advanced/high-risk MDS. Decreased proliferation of non-lymphoid CD34+ and NRBC precursors was significantly associated with adverse disease features, shorter overall survival (OS) and transformation to AML, both in the whole series and when low- and high-risk MDS patients were separately considered, the PI of NRBC emerging as the most powerful independent predictor for OS and progression to AML. In conclusion, assessment of the PI of NRBC, and potentially also of other compartments of BM precursors (e.g.: myeloid CD34+ HPC), could significantly contribute to a better management of MDS. PMID:22952954

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

    Institute of Scientific and Technical Information of China (English)

    Rolf D Burghardt; Thorsten Gehrke; Daniel Kendoff; Ulrich St(o)ckle; Sebastian Siebenlist

    2013-01-01

    Compartment syndrome of the thigh is a rare condition,potentially resulting in devastating functional outcome.Increasing intracompartmental pressure which suppresses micmcirculation 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.

  1. Investigation of psychological traits in patients with chronic abdominal pain syndrome

    Directory of Open Access Journals (Sweden)

    A. A. Tokareva

    2012-01-01

    Full Text Available Subjects of the study were 100 chronic abdominal pain syndrome inpatients assigned to subgroups of different level of significance of psychological factors for the development of pain syndrome, different self-assessed pain level (utilizing visual analog scale, and different type of attitude towards disease (by the Bekhterev Institute Personality Inventory. Character and psychodynamic specialties were assessed in the aforementioned subgroups following to assignment. Proved by clinical and psychometric methods diagnosis of somatoform pain disorder was used as an indicator of high importance of psychological determinants. Differences between subgroups were assessed by the kit of questionnaires (Beck Depression Inventory, Spielberger Anxiety Scales, Wasserman Social Frustration Inventory, TAS, MCMI-III and projective tests (Luscher and Szondi tests. Interference between psychosomatic and demographic characteristics within the sample, and accuracy of assigning subjects to subgroups were discussed. Interpretation of the acquired data with implications for psychotherapists was offered.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Abdominal lymphangioleiomyomatosis in a man with Klinefelter syndrome: the first reported case.

    Science.gov (United States)

    Fiore, Maria Grazia; Sanguedolce, Francesca; Lolli, Ivan; Piscitelli, Domenico; Ricco, Rosalia

    2005-04-01

    Lymphangioleiomyomatosis (LAM) is an uncommon progressive disease characterized by a hamartomatous tumor-like proliferation of smooth muscle cells that occurs most often in women. This disease commonly involves the lymph nodes, lungs, and mediastinum, and rarely the abdominal sites. We report a case of mesenteric LAM occurring in a 37-year-old man affected by Klinefelter syndrome with a 17-year history of androgen replacement therapy. Histology revealed a hamartomatous proliferation of spindle cells surrounding multiple ectatic lymphatic spaces intermixed with lymphatic follicles. When subjected to immunohistochemical studies, the tumor cells stained positive for muscular markers and negative for estrogen, progesterone, and androgen receptors. The occurrence of LAM in association with Klinefelter syndrome has never been reported in the literature and could represent a further clue in the still unclear pathogenesis of this disease.

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

    Science.gov (United States)

    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.

  5. Gender differences in the prevalence and development of metabolic syndrome in Chinese population with abdominal obesity.

    Directory of Open Access Journals (Sweden)

    Shaoyong Xu

    Full Text Available BACKGROUND: Not all the people with metabolic syndrome (MS have abdominal obesity (AO. The study aimed to investigate gender differences in the prevalence and development of MS in Chinese population with abdominal obesity, which has rarely been reported. METHODS: Data were obtained from the 2007-08 China National Diabetes and Metabolic Disorders Study, and participants were divided into two samples for analysis. Sample 1 consisted of 19,046 people with abdominal obesity, while sample 2 included 2,124 people meeting pre-specified requirements. Survival analysis was used to analyze the development of MS. RESULTS: The age-standardized prevalence of MS in Chinese population with AO was 49.5%. The prevalence in males (73.7% was significantly higher than that in females (36.9%. Males had significantly higher proportions of combinations of three or four MS components than females (36.4% vs. 30.2% and 18.4% vs. 5%, respectively. MS developed quick at first and became slow down later. Half of the participants with AO developed to MS after 3.9 years (95% CI: 3.7-4.1 from the initial metabolic abnormal component, whereas 75% developed to MS after 7.7 years (95% CI: 7.5-7.9. CONCLUSION: Compared with females, Chinese males with AO should receive more attention because of their higher prevalence of MS and its components, more complex and risky combinations of abnormal components, and faster development of MS.

  6. Major donor area complication after a mandibular reconstruction with an osseous fibular free flap: pseudo-compartment syndrome.

    Science.gov (United States)

    Kuvat, Samet Vasfi; Keklik, Barş; Özden, Burcu Celet; Uçar, Adem; Cizmeci, Orhan

    2012-03-01

    The popularity of the fibular free flap in mandibular reconstructions is persisting, and major donor area complications rarely occur after fibular free flap operations. Still, we have observed a pseudo-compartment syndrome in a 52-year-old patient on the 12th postoperative day after a mandibular reconstruction with a fibular free flap. When an obstruction in the deep venous system (deep vein thrombosis) was observed in the Doppler ultrasound-guided imaging, the patient has been taken to the operating room for an emergency surgery and the donor area has been completely reopened (in the manner of a fasciotomy). After this procedure, the circulation in the foot appeared to return to normal. The exposed muscles of the patient, who was started on a low-molecular-weight heparin treatment for the deep vein thrombosis, have been closed with skin grafts on the 10th day. No functional loss was observed during the 2-month follow-up period.

  7. A case's root cause analysis of osteofascial compartment syndrome induced by radial artery puncture and its defensive strategy

    Institute of Scientific and Technical Information of China (English)

    Feng-Ying Kang; Yang Yang; Yu-Ping Tong; Ya-Li Hu; Ning-Ning Xue

    2016-01-01

    Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis. Methods: We analyzed an adverse event using cheese model analysis, “fish bone” analysis, root cause analysis, and other methods. Results: There are three root causes leading to an adverse event:operation technique, assessment of the disease, and informing patient families. However, there are many reasons to promote the occurrence and development of the event. Conclusions: We should analyze and manage the adverse events in patients from the point of view of a system. Developing the measures of a system defense can enhance patient safety and create a good safety culture.

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

    DEFF Research Database (Denmark)

    Kotronen, Anna; Yki-Järvinen, Hannele; Sevastianova, Ksenia

    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...... quantitative contributions of IA and liver fat to components of the syndrome, fasting serum (fS) insulin, and liver enzymes and measures of hepatic insulin sensitivity in 356 subjects (mean age 42 years, mean BMI 29.7 kg/m²) in whom liver fat and abdominal fat volumes were measured. IA and liver fat contents...... were correlated (r = 0.65, P fat, liver fat or IA fat explained variation in fS-triglyceride (TG) and high-density lipoprotein (HDL) cholesterol, plasma glucose, insulin and liver enzyme concentrations, and hepatic...

  9. 封闭负压引流技术治疗骨筋膜室综合征%Vacuum Sealing Drainage Therapy in the Osteo -Fascial Compartment Syndrome

    Institute of Scientific and Technical Information of China (English)

    刘涛; 于博凡; 王义生; 陈光; 李晓彬

    2012-01-01

    Objective To explore the clinical effects of vacuum sealing drainage in the patients of osteo -fascia compartment syndrome. Methods To review and analysis clinical data of the application of Vacuum Sealing Drainage on 20 cases of fracture in extremities with oste - ofascial compartment syndromes. Results All the 20 cases of oste - ofascial compartment syndromes were controlled rapidly,swelling of extremities subsided quickly,and the recover time was short. Conclusions Vacuum Sealing Drainage is the effective method for the treatment of oste - ofascial compartment syndromes. It is meaningful tn accelerate extensive application of VSD.%目的 探讨封闭式负压引流技术(VSD)在骨筋膜室综合征中的治疗作用.方法 回顾性分析20例四肢骨折并发骨筋膜室综合征患者采用封闭式负压引流技术治疗的临床资料.结果 20例骨筋膜室综合征患者病情全部得到迅速控制,肢体肿胀消退快,愈合时间短.结论 封闭式负压引流技术是治疗骨筋膜间隙综合征的有效措施,值得推广应用.

  10. Past and present in abdominal surgery management for Cushing’s syndrome

    Directory of Open Access Journals (Sweden)

    Ramon Vilallonga

    2014-03-01

    Full Text Available Introduction: Data on specific abdominal surgery and Cushing’s syndrome are infrequent and are usually included in the adrenalectomy reports. Current literature suggests the feasibility and reproducibility of the surgical adrenalectomies for patients diagnosed with non-functioning tumours and functioning adrenal tumours including pheochromocytoma, Conn’s syndrome and Cushing’s syndrome. Discussion: Medical treatment for Cushing’s syndrome is feasible but follow-up or clinical situations force the patient to undergo a surgical procedure. Laparoscopic surgery has become a gold standard nowadays in a broad spectrum of pathologies. Laparoscopic adrenalectomies are also standard procedures nowadays. However, despite the different characteristics and clinical disorders related to the laparoscopically removed adrenal tumours, the intraoperative and postoperative outcomes do not significantly differ in most cases between the different groups of patients, techniques and types of tumours. Tumour size, hormonal type and surgeon’s experience could be different factors that predict intraoperative and postoperative complications. Transabdominal and retroperitoneal approaches can be considered. Outcomes for Cushing’s syndrome do not differ depending on the surgical approach. Novel technologies and approaches such as single-port surgery or robotic surgery have proven to be safe and feasible. Conclusion: Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery. Single-port access and robotic surgery can be performed but more data are required to identify their correct role between the different surgical approaches. Factors such as surgeon’s experience, tumour size and optimal technique can affect the outcomes of this surgery.

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

    DEFF Research Database (Denmark)

    Min, Josine L; Nicholson, George; Halgrimsdottir, Ingileif

    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, ...

  12. In women with polycystic ovary syndrome and obesity, loss of intra-abdominal fat is associated with resumption of ovulation

    NARCIS (Netherlands)

    Kuchenbecker, W.K.H.; Groen, H.; van Asselt, S.J.; Bolster, J.H.T.; Zwerver, J.; Slart, R.H.J.; van der Jagt, E.J.; Kobold, A.C.M.; Wolffenbuttel, B.H.R.; Land, J.A.; Hoek, A.

    2011-01-01

    BACKGROUND: It is not clear why some anovulatory women with polycystic ovary syndrome (PCOS) and obesity resume ovulation and others remain anovulatory after weight loss. The objective of this study was to compare the changes in body fat distribution and specifically intra-abdominal fat (IAF) and su

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

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    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

  14. A case of abdominal aortic thrombosis associated with the nephrotic syndrome

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    Jannet Labidi

    2017-01-01

    Full Text Available Thromboembolic disease is an important and frequent complication in patients with the nephrotic syndrome (NS, and the consequences are often severe. Usually, the venous system is affected. Arterial thrombosis has rarely been reported and occurs mainly in children. We report the case of a 27-year-old man with a history of NS due to focal and segmental glomerulosclerosis resistant to steroids and cyclosporine, admitted for bilateral pain in the calves. Aortogram revealed a suspended thrombus in the abdominal aorta just below the origin of the renal arteries with embolism into the left tibioperoneal trunk and the right anterior tibial artery. Endarterectomy was performed followed by systemic heparinization with a good outcome. Arterial thrombosis is rare and must be prevented.

  15. Spontaneous Regression of Polyposis following Abdominal Colectomy and Helicobacter pylori Eradication for Cronkhite-Canada Syndrome

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    Kimitoshi Kato

    2013-03-01

    Full Text Available The etiology of Cronkhite-Canada syndrome (CCS remains unknown and many cases are refractory to treatment. Therefore, new therapies are urgently needed. Furthermore, a number of CCS cases with gastrointestinal carcinoma have been reported. Our patient had rapid onset of CCS and early development of colon carcinoma associated with adenomas. High anterior resection of the sigmoid colon and ileostomy were performed, and her symptoms and endoscopic and histological findings improved. Helicobacter pylori eradication was carried out 2 years later, surgical closure of an ileal fistula the following year. After 4 months, upper gastrointestinal endoscopy and colonoscopy showed that the CCS lesions had completely disappeared, and biopsies confirmed a normal stomach, duodenum, ileum and colon histologically. The patient has maintained remission for 2 years. The clinical course of this case, showing complete regression of CCS lesions following abdominal colectomy and H. pylori eradication, suggests the significance of H. pylori infection in the treatment of CCS.

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

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    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.

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

    DEFF Research Database (Denmark)

    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 investigate whether patients with Subacromial Impingement Syndrome (SIS) were able to selectively activate the individual compartments within the trapezius muscle, with and without EMG biofeedback to the same extent as healthy controls (No-SIS). Fifteen SIS and 15 No-SIS participated in the study. Sessions...... with and without visual biofeedback were conducted. Surface EMG was recorded from four compartments of the trapezius muscle. Selective activation was defined as activation above 12% with other muscle parts below 1.5% or activation ratio at or above 95% of the total activation. Without biofeedback significantly...

  18. Dephosphorylation and subcellular compartment change of the mitotic Bloom's syndrome DNA helicase in response to ionizing radiation.

    Science.gov (United States)

    Dutertre, Stéphanie; Sekhri, Redha; Tintignac, Lionel A; Onclercq-Delic, Rosine; Chatton, Bruno; Jaulin, Christian; Amor-Guéret, Mounira

    2002-02-22

    Bloom's syndrome is a rare human autosomal recessive disorder that combines a marked genetic instability and an increased risk of developing all types of cancers and which results from mutations in both copies of the BLM gene encoding a RecQ 3'-5' DNA helicase. We recently showed that BLM is phosphorylated and excluded from the nuclear matrix during mitosis. We now show that the phosphorylated mitotic BLM protein is associated with a 3'-5' DNA helicase activity and interacts with topoisomerase III alpha. We demonstrate that in mitosis-arrested cells, ionizing radiation and roscovitine treatment both result in the reversion of BLM phosphorylation, suggesting that BLM could be dephosphorylated through the inhibition of cdc2 kinase. This was supported further by our data showing that cdc2 kinase activity is inhibited in gamma-irradiated mitotic cells. Finally we show that after ionizing radiation, BLM is not involved in the establishment of the mitotic DNA damage checkpoint but is subjected to a subcellular compartment change. These findings lead us to propose that BLM may be phosphorylated during mitosis, probably through the cdc2 pathway, to form a pool of rapidly available active protein. Inhibition of cdc2 kinase after ionizing radiation would lead to BLM dephosphorylation and possibly to BLM recruitment to some specific sites for repair.

  19. Compartment syndrome like picture in metaphyseal comminuted fracture of tibia treated by locking plate due to tight closure

    Directory of Open Access Journals (Sweden)

    Prafulla Herode

    2013-01-01

    Full Text Available A 22-year-old male came to casualty on 5 th May 2012 after a fall from motorcycle. He complained of excruciating pain and swelling over right knee. There was an open wound of 7 × 2 cm over supra-patellar region and diffuse swelling over knee joint with severe tenderness over proximal aspect of right tibia. X-ray showed intra-articular fracture of proximal tibia extending to diaphysis classified as type 6 by Schatzker classification for proximal tibia, with fibula shaft transverse fracture. The skin over the fracture was contused. Debridement with primary wound closure was done in emergency. Skeletal traction was applied through a lower tibial Steinman pin. Patient was operated after 15 days when wound healed and swelling subsided. Locking plate was applied on medial aspect using Minimally invasive percutaneous plate osteosysthesis (MIPPO technique. Post-operatively over 4 hours patient developed severe pain and swelling in operated leg which mimicked compartment syndrome. Suture removal was done immediately in the ward from the distal aspect, which relieved the symptoms but lead to exposure of the plate. A rotational flap was done to cover the plate in coordination with a plastic surgeon on the next day.

  20. 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

    NARCIS (Netherlands)

    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

  1. Abdominal Cocoon Syndrome (Idiopathic Sclerosing Encapsulating Peritonitis: How Easy Is Its Diagnosis Preoperatively? A Case Report

    Directory of Open Access Journals (Sweden)

    Julius A. A. Awe

    2013-01-01

    Full Text Available The abdominal cocoon syndrome (or idiopathic encapsulating peritonitis is a rare cause of intestinal obstruction. It has been reported predominantly in adolescent girls living in tropical/subtropical region in which diagnosis is only made at laparotomy in most cases. The cause and pathogenesis of the condition have not been elucidated. Prolonged administration of practalol, meconium peritonitis, and tuberculous infection of the female genital tract have been incriminated as possible causes. The author reports a case of a female patient with recurrent intestinal obstruction treated for years but failed to settle down on conservative treatment during her last hospital admission and had to undergo surgery. Preoperative diagnosis of this syndrome as the cause of her intestinal obstruction was not made until at laparotomy, when a thick fibrotic peritoneal wrapping of the bowel in a concertina-like fashion with some adhesions was found. Excision of this membrane and adhesiolysis were carried out without any need for bowel resection, and this led to relief of the obstruction and patient’s complete recovery. Awareness of this benign condition in the differential diagnosis of intestinal obstruction will result in early diagnosis and correct management and prevent unnecessary bowel resections and bad outcomes.

  2. The role of prostacyclin in the mesenteric traction syndrome during anesthesia for abdominal aortic reconstructive surgery.

    Science.gov (United States)

    Gottlieb, A; Skrinska, V A; O'Hara, P; Boutros, A R; Melia, M; Beck, G J

    1989-03-01

    Mesenteric traction syndrome consists of sudden tachycardia, hypotension, and cutaneous hyperemia, and frequently occurs during mesenteric traction in patients undergoing abdominal aortic aneurysm (AAA) reconstructive surgery. The etiology and clinical impact of this phenomenon are unknown, but the symptoms suggest a release of vasoactive materials from the mesenteric vascular bed. Thirty-one patients who underwent AAA surgery were studied. Mesenteric traction was accompanied by a decrease in systolic (p = 0.005) and diastolic (p less than 0.05) blood pressures, and in systemic vascular resistance (p less than 0.005), and was accompanied by an increase in heart rate (HR) (p less than 0.005), and cardiac output (p = 0.01). These hemodynamic changes coincided with an increase (p less than 0.001) in plasma concentrations of 6-keto-prostaglandin F1 (6-K-PGF1). No apparent change was found in prostaglandin E2, thromboxane B2, and histamine concentrations. The concentration of 6-K-PGF1 was correlated with diastolic blood pressure (r = -0.52, p less than 0.005) and HR (r = 0.65, p less than 0.001). Cutaneous hyperemia was observed in 58% of the patients. In an additional six patients, who had taken aspirin daily before AAA surgery, no significant changes were observed in the hemodynamic measurements or 6-K-PGF1 concentrations. These data suggest that mesenteric traction syndrome may be mediated at least in part by a selective release of prostacyclin.

  3. Churg-Strauss Syndrome Leading to Small Bowel Infarction: An Unusual Case of Abdominal Pain in a Young Patient

    Directory of Open Access Journals (Sweden)

    Sunil Sookram

    1998-01-01

    Full Text Available A 33-year-old man with a history of severe asthma presented to the emergency department with a week-long history of severe unrelenting abdominal pain, nausea and decreased appetite. He was admitted to hospital, and routine gastrointestinal investigations were performed, which did not elucidate the cause of his abdominal pain. Exploratory laparotomy demonstrated patchy infarction of the entire small bowel, characteristic of Churg-Strauss syndrome. The patient subsequently underwent 12 separate laparotomies to salvage surviving small bowel. The patient is maintained on total parenteral nutrition.

  4. Trafficking-deficient hERG K⁺ channels linked to long QT syndrome are regulated by a microtubule-dependent quality control compartment in the ER.

    Science.gov (United States)

    Smith, Jennifer L; McBride, Christie M; Nataraj, Parvathi S; Bartos, Daniel C; January, Craig T; Delisle, Brian P

    2011-07-01

    The human ether-a-go-go related gene (hERG) encodes the voltage-gated K(+) channel that underlies the rapidly activating delayed-rectifier current in cardiac myocytes. hERG is synthesized in the endoplasmic reticulum (ER) as an "immature" N-linked glycoprotein and is terminally glycosylated in the Golgi apparatus. Most hERG missense mutations linked to long QT syndrome type 2 (LQT2) reduce the terminal glycosylation and functional expression. We tested the hypothesis that a distinct pre-Golgi compartment negatively regulates the trafficking of some LQT2 mutations to the Golgi apparatus. We found that treating cells in nocodazole, a microtubule depolymerizing agent, altered the subcellular localization, functional expression, and glycosylation of the LQT2 mutation G601S-hERG differently from wild-type hERG (WT-hERG). G601S-hERG quickly redistributed to peripheral compartments that partially colocalized with KDEL (Lys-Asp-Glu-Leu) chaperones but not calnexin, Sec31, or the ER golgi intermediate compartment (ERGIC). Treating cells in E-4031, a drug that increases the functional expression of G601S-hERG, prevented the accumulation of G601S-hERG to the peripheral compartments and increased G601S-hERG colocalization with the ERGIC. Coexpressing the temperature-sensitive mutant G protein from vesicular stomatitis virus, a mutant N-linked glycoprotein that is retained in the ER, showed it was not restricted to the same peripheral compartments as G601S-hERG at nonpermissive temperatures. We conclude that the trafficking of G601S-hERG is negatively regulated by a microtubule-dependent compartment within the ER. Identifying mechanisms that prevent the sorting or promote the release of LQT2 channels from this compartment may represent a novel therapeutic strategy for LQT2.

  5. A case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery.

    Science.gov (United States)

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-02-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was accomplished with a nonisland pedicled foot fillet flap. Various foot fillet flaps may be used acutely as a free or an island pedicled flap, but dissection of the vascular pedicle may be difficult in a chronically inflamed wound because of inflammation and adhesions to surrounding tissue. The nonisland pedicled foot fillet flap may be considered as a useful option for treatment of a chronically inflamed stump wound after below-knee amputation.

  6. Measurement of waist circumference at different sites affects the detection of abdominal obesity and metabolic syndrome among psychiatric patients.

    Science.gov (United States)

    Lin, Chao-Cheng; Yu, Shun-Chieh; Wu, Bo-Jian; Chang, Da-Jen

    2012-05-30

    There is a lack of understanding about the impact of different waist circumference (WC) measurements on the detection of abdominal obesity and metabolic syndrome in psychiatric patients. This cross-sectional study included a total of 382 inpatients with schizophrenia-related disorders to assess each component of metabolic syndrome. WC was measured at the lowest rib, midpoint between the iliac crest and lowest rib, iliac crest, minimal waist, and umbilicus. Logistic regression analysis was performed to examine the ability of WC at each site to predict the presence of metabolic risk clustering. The mean WC values for all sites were significantly different from each other. The measurement site had an influence on the prevalence of abdominal obesity (30-38.2% in men and 53.9-86.3% in women). The influence on the prevalence of metabolic syndrome was greater with the International Diabetes Federation (IDF) criteria (19.3-23.9% in men and 29.4-43.1% in women) than with the Adult Treatment Panel III (ATP III) criteria (26.1-28.6% in men and 37.3-44.1% in women). The areas under the receiver operating characteristic curve for metabolic risk clustering were highest at the umbilicus and midpoint. Given that the WC measurement protocol has substantial influence on the prevalence of abdominal obesity and metabolic syndrome, a predefined measurement site is required for all psychiatric studies.

  7. Giant desmoid tumor of the abdominal wall in a patient with Gardner Syndrome

    Directory of Open Access Journals (Sweden)

    Daniel Paulino Santana

    2012-09-01

    Full Text Available Gardner syndrome (GS is a rare entity characterized by a triad of familial colonic polyposis, multiple osteomas and soft tissue tumors, including desmoid tumor (DT. This is a case report of a 30 year-old patient with GS who developed giant DT in the abdominal wall after undergoing several laparotomies. The patient has taken a long time to search for medical care, and at first he saw another team that refused to operate him by judging the lesion unresectable. The surgery in our department was performed in three steps. Initially, we resected the lesion with macroscopic margins, and as there were small bowel adhesions in the tumor, we performed enterectomy and closed using the "Bogotá" technique, with skin closure on the bag. On the fourth postoperative day (POD, we reoperated the abdomen without identifying any signs of fistula. On the seventh POD there was another surgical intervention, this time to insert a double-sided mesh. The patient recovered well, and had no debilitating motor deficit, despite the extensive resection of the abdominal muscles. Curative treatment of DT is based on surgical resection and only sequential surveillance allows us an early diagnosis, when the lesion is still resectable.Tumor desmoide gigante de parede abdominal em paciente portador da Síndrome de Gardner. A Síndrome de Gardner (SG é uma entidade rara caracterizada pela tríade polipose colônica familial, múltiplos osteomas e tumores de tecidos moles, dentre eles o tumor desmoide (TD. Tratou-se de um relato de caso de um paciente de 30 anos, com SG que evoluiu com TD gigante em parede abdominal, após ser submetido a diversas laparotomias prévias. O paciente levou longo tempo para procurar o serviço de cirurgia, passando por outra equipe que se negou a abordá-lo por julgar a lesão irressecável. A cirurgia no nosso serviço se deu em três tempos. Inicialmente, foi feita a ressecção da lesão com margens macroscópicas e, por haver aderências de al

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  10. 外侧单切口四间室减压术治疗小腿筋膜间室综合征%Treatment of acute leg compartment syndromes by lateral single-incision four-compartment fasciotomy

    Institute of Scientific and Technical Information of China (English)

    陈华; 唐佩福; 郝明; 张巍; 高远; 梁向党; 张群; 郭义柱; 陶笙; 张立海

    2015-01-01

    目的:评价外侧单切口四间室筋膜间室减压术( single-incision four-compartment fasciotomy, SICF )治疗急性小腿筋膜间室综合征( compartment syndrome,CS )的临床效果。方法2011年1月至2013年12月,我院收治32例(32侧)胫腓骨骨折合并小腿 CS 患者。男20例,女12例;年龄25~50岁,平均33.4岁;左侧14例,右侧18例;闭合损伤20例,开放损伤12例( Gustilo-Anderson I 型8例,II 型4例)。受伤至手术切开减压时间5~16 h,中位时间10 h。术中采用外侧单切口进行小腿四间室减压。结果手术时间40~90 min,平均70.0 min;切口长20~25 cm,平均22.4 cm。术后切口均愈合,无切口感染、下肢深静脉血栓形成、腓浅神经损伤等并发症。32例随访12~24个月随访,平均16个月,骨折均愈合,无骨感染发生。结论 SICF 手术技术软组织损伤相对较小、外科显露清楚、小腿筋膜四间室充分减压,是双切口减压术一种很好的替代方法。%Objective To evaluate clinical effects of single-incision four-compartment fasciotomy ( SICF ) in the treatment of acute leg compartment syndromes.Methods From January 2011 to December 2013, 32 patients ( 32 sides ) with acute leg compartment syndromes and tibia and ifbula diaphyseal fractures were treated with SICF techniques. This series covered 20 males and 12 females with the average age of 33.4 years ( range: 25-50 years ). The left leg was involved in 14 cases, while the right in 18. Twenty patients presented with close injuries, and the other 12 sustained from open fractures ( Gustilo-Anderson I in 8 cases and II in 4 ). The time from injury to operation ranged from 5hrs to 16 hrs ( neutral: 10 hrs ). Decompression was done in all cases by SICF technique.Results The operation time ranged 40-90 mins ( mean: 70 mins ). The length of incision ranged 20-25 cm with a mean of 22.4 cm. The wounds in all cases healed well without any incision related

  11. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

    Science.gov (United States)

    Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

    2015-01-01

    Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing

  12. HRV biofeedback for pediatric irritable bowel syndrome and functional abdominal pain: a clinical replication series.

    Science.gov (United States)

    Stern, Mark J; Guiles, Robert A F; Gevirtz, Richard

    2014-12-01

    Irritable bowel syndrome (IBS) and Functional Abdominal Pain (FAP) are among the most commonly reported Functional Gastrointestinal Disorders. Both have been associated with varying autonomic dysregulation. Heart Rate Variability Biofeedback (HRVB) has recently begun to show efficacy in the treatment of both IBS and FAP. The purpose of this multiple clinical replication series was to analyze the clinical outcomes of utilizing HRVB in a clinical setting. Archival data of twenty-seven consecutive pediatric outpatients diagnosed with IBS or FAP who received HRVB were analyzed. Clinical outcomes were self-report and categorized as full or remission with patient satisfaction, or no improvement. Qualitative reports of patient experiences were also noted. Full remission was achieved by 69.2 % and partial remission was achieved by 30.8 % of IBS patients. Full remission was achieved by 63.6 % and partial remission was achieved by 36.4 % of FAP patients. No patients in either group did not improve to a level of patient satisfaction or >50 %. Patient's commonly reported feeling validated in their discomfort as a result of psychophysiological education. Results suggest that HRVB is a promising intervention for pediatric outpatients with IBS or FAP. Randomized controlled trials are necessary to accurately determine clinical efficacy of HRVB in the treatment of IBS and FAP.

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Prevention and Nursing of Osteofascial Compartment Syndrome%骨筋膜室综合征的预防和护理

    Institute of Scientific and Technical Information of China (English)

    魏娟娟; 全英

    2014-01-01

    骨筋膜室综合征又称急性筋膜间室综合征,是骨科常见的严重合并征之一,骨筋膜室内的肌肉、神经因急性缺血、缺氧而产生的一系列症状和体征,如不及时治疗会迅速发展为肢体坏死或坏疽,严重者可并发肾功能衰竭而危及生命。我科对20例患者严密观察,细心护理,及时治疗,杜绝疾病的进一步发展,避免了不良后果的发生。%Osteofascial compartment syndrome is also cal ed acute compartment syndrome is common in Department of orthopedics,serious and characteristic,a series of symptoms and signs compartment muscles,nerve because of acute ischemia,hypoxia and produces,if not timely treatment for the rapid development of limb necrosis and gangrene,can be complicated by severe renal failure and endanger life.In our department,20 cases of close observation,careful nursing,timely treatment,the further development of stopping the disease,avoiding the adverse consequences,wil nurse now experience reports as fol ows.

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

    Science.gov (United States)

    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.

  16. A home-based treadmill training reduced epicardial and abdominal fat in postmenopausal women with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Gabriel Fornieles González

    Full Text Available Introduction: The current study was designed to determine the effect of home-based treadmill training on epicardial and abdominal adipose tissue in postmenopausal women with metabolic syndrome (MS. A secondary objective was to identify significant correlations between imaging and conventional anthropometric parameters. Material and methods: Sixty postmenopausal women with MS volunteered for the current trial. Thirty were randomly assigned to perform a supervised home-based 16-week treadmill training program, 3 sessions/week, consisting of a warm-up, 30-40 min treadmill exercise (increasing 5-minutes each 4-weeks at a work intensity of 60-75% of peak heart rate (increasing 5% each 4-weeks and cooling-down. Epicardial fat thickness (EFT was assessed by echocardiography. Abdominal fat mass in the lumbar regions L1-L4 and L4-L5 was determined by dual X-ray absorptiometry. Results: Epicardial fat thickness and abdominal fat percentages were significantly improved after the completion of the training program. Another striking feature of the current study was the moderate correlation that was found between EFT and waist circumference (WC. Conclusion: Home-based treadmill training reduced epicardial and abdominal fat in postmenopausal women with MS. A secondary finding was that a moderate correlation was found between EFT and WC. While current investigations are promising, future studies are still required to consolidate this approach in clinical application.

  17. 儿童多发性创伤急性骨筋膜室综合征%Acute osteofascial compartment syndrome in children with multiple injury

    Institute of Scientific and Technical Information of China (English)

    唐盛平

    2009-01-01

    @@ 急性骨筋膜室综合征(acute osteofascial compartment syndrome,AOCS)是四肢某个部位的筋膜室内,组织的压力增加导致该筋膜室中神经和肌肉组织的血循环障碍,进一步出现神经和肌肉的缺血坏死,后期发生纤维化,引起肢体功能障碍,甚至坏死,出现严重残疾.

  18. Clinical evaluation of sivelestat for acute lung injury/acute respiratory distress syndrome following surgery for abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Tsuboko Y

    2012-10-01

    Full Text Available Yoshiaki Tsuboko,1 Shinhiro Takeda,1,2 Seiji Mii,1 Keiko Nakazato,1 Keiji Tanaka,2 Eiji Uchida,3 Atsuhiro Sakamoto11Department of Anesthesiology, Nippon Medical School, 2Intensive Care Unit and Cardiac Care Unit, Nippon Medical School Hospital, 3Department of Surgery, Nippon Medical School, Tokyo, JapanBackground: The efficacy of sivelestat in the treatment of acute lung injury/acute respiratory distress syndrome (ALI/ARDS has not been established. In part, this is due to the wide variety of factors involved in the etiology of ALI/ARDS. In this study, we examined the efficacy of sivelestat in patients with ALI/ARDS associated with abdominal sepsis.Methods: The subjects were 49 patients with ALI/ARDS after surgery for abdominal sepsis. The efficacy of sivelestat was retrospectively assessed in two treatment groups, ie, a sivelestat group (n = 34 and a non-sivelestat group (n = 15.Results: The sivelestat group showed significant improvements in oxygenation, thrombocytopenia, and multiple organ dysfunction score. The number of ventilator days (6.6 ± 6.1 versus 11.1 ± 8.4 days; P = 0.034 and length of stay in the intensive care unit (8.5 ± 6.2 versus 13.3 ± 9.5 days; P = 0.036 were significantly lower in the sivelestat group. The hospital mortality rate decreased by half in the sivelestat group, but was not significantly different between the two groups.Conclusion: Administration of sivelestat to patients with ALI/ARDS following surgery for abdominal sepsis resulted in early improvements of oxygenation and multiple organ dysfunction score, early ventilator weaning, and early discharge from the intensive care unit.Keywords: sivelestat, acute lung injury, acute respiratory distress syndrome, abdominal sepsis

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

    Science.gov (United States)

    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 (p<0.05) increases with exercise for volunteers, and a increased significantly (p<0.05) in volunteers. At the group level, response factors of all three parameters showed trends differentiating controls from CECS patients, with patients showing smaller diameter changes (p=0.07), and larger permeability increases (p=0.07) than controls. Conclusions Time-dependent diffusion measurements 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Análise da correlação entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal Analysis of correlation between pseudoexfoliation syndrome and aneurysm of the abdominal aorta

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Ponte Pierre Filho

    2004-06-01

    Full Text Available OBJETIVO: Examinar a correlação sugerida entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal. MÉTODOS: Sessenta e cinco pacientes recentemente operados por aneurisma de aorta abdominal e 51 controles com aterosclerose periférica, sem aneurisma, submeteram-se ao exame oftalmológico sob dilatação pupilar para investigar a presença de síndrome de pseudo-exfoliação. RESULTADOS: Não houve diferenças estatisticamente significantes entre a média de idade, distribuição por sexo e raça entre os 2 grupos (p > 0,05. Dois dos 65 pacientes com aneurisma de aorta e um dos 51 controles apresentaram síndrome de pseudo-exfoliação (p = 1,00. CONCLUSÃO: A prevalência de síndrome de pseudo-exfoliação em pacientes operados por aneurisma de aorta abdominal e em pacientes com aterosclerose periférica foi similar. Este achado não confirma a associação proposta entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal.PURPOSE: To investigate the suggested association between pseudoexfoliation syndrome and aneurysm of the abdominal aorta. METHODS: 65 patients recently operated for abdominal aortic aneurysm and 51 controls with peripheral atherosclerosis, without aneurysm, underwent an ophthalmologic examination under pupillary dilatation to detect the presence of pseudoexfoliation syndrome. RESULTS: There were no significant differences regarding mean age and distribution by gender and race between the groups (p > 0.05. Two of 65 patients with aortic aneurysm and one of 51 controls presented pseudoexfoliation syndrome (p = 1.00. CONCLUSION: The prevalence of pseudoexfoliation syndrome in patients operated for abdominal aortic aneurysm and in patients with peripheral atherosclerosis were similar. This finding does not support the proposed association between pseudoexfoliation syndrome and abdominal aortic aneurysm.

  2. Early Diagnosis and Treatment of Osteofascial Compartment Syndrome%骨筋膜室综合症的早期诊断及治疗

    Institute of Scientific and Technical Information of China (English)

    哈力别克

    2016-01-01

    Objective To investigate the osteofascial compartment syndrome of etiology, diagnosis and treatment.Methods summarize and analyze the cases of bone fascia syndrome pathogenesis, clinical manifestation, diagnosis and treatment.Results the group of 39 cases, male 31 cases, female 8 cases, aged 16-58 years. Injury site, the calf and forearm, thigh and foot in 4 cases. The close observation of non operative treatment, and the rest underwent compartment decompression, 10-15 days delayed suture tension, free skin graft.Conclusion early and correct judgment of the injured limb ischemia causes, the corresponding operation and postoperative anticoagulation, expansion, dehydration, anti Inflammation and other treatment is the basic measure of prevention and treatment of the compartment syndrome of the bone, must not simply cut through the water.%目的:探讨骨筋膜室综合征的病因、诊断及治疗。方法总结分析例骨筋膜综合征发病的原因、临床表现、诊断及治疗。结果本组39例,男性31例,女8例,年龄16~58岁。致伤部位:小腿25例,前臂8例,大腿2例,足部4例。其中6例在严密观察下非手术治疗,其余均行筋膜室切开减压,10-15天延期缝合,张力大者,行游离植皮。结论早期正确判断伤肢缺血的病因,进行相应的手术及术后抗凝、扩容、脱水、抗炎等治疗是防治骨筋膜室综合征的根本措施,切不可单纯行切开减压水。

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

    Directory of Open Access Journals (Sweden)

    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.

  4. The loss of Gnai2 and Gnai3 in B cells eliminates B lymphocyte compartments and leads to a hyper-IgM like syndrome.

    Directory of Open Access Journals (Sweden)

    Il-Young Hwang

    Full Text Available B lymphocytes are compartmentalized within lymphoid organs. The organization of these compartments depends upon signaling initiated by G-protein linked chemoattractant receptors. To address the importance of the G-proteins Gαi2 and Gαi3 in chemoattractant signaling we created mice lacking both proteins in their B lymphocytes. While bone marrow B cell development and egress is grossly intact; mucosal sites, splenic marginal zones, and lymph nodes essentially lack B cells. There is a partial block in splenic follicular B cell development and a 50-60% reduction in splenic B cells, yet normal numbers of splenic T cells. The absence of Gαi2 and Gαi3 in B cells profoundly disturbs the architecture of lymphoid organs with loss of B cell compartments in the spleen, thymus, lymph nodes, and gastrointestinal tract. This results in a severe disruption of B cell function and a hyper-IgM like syndrome. Beyond the pro-B cell stage, B cells are refractory to chemokine stimulation, and splenic B cells are poorly responsive to antigen receptor engagement. Gαi2 and Gαi3 are therefore critical for B cell chemoattractant receptor signaling and for normal B cell function. These mice provide a worst case scenario of the consequences of losing chemoattractant receptor signaling in B cells.

  5. Diagnosis and treatment of acute foot compartment syndrome%急性足部骨筋膜室综合征的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    孙海波; 潘进社

    2011-01-01

    @@ 相对于前臂和小腿,足部骨筋膜室综合征 (osteofascial compartment syndrome,OCS)的发生率较低,交通伤中约为6%[1],挤压伤中约为41%[2].一旦发生漏诊,会引起严重的并发症,如爪形趾、慢性疼痛、僵硬和神经功能丧失,严重者甚至截肢等.近年来国内文献报道较少,现就足部OCS的诊断及治疗研究进展综述如下.

  6. Acute compartment syndrome of the forearm after paravasation of contrast medium. Case report; Akutes Kompartmentsyndrom des Unterarms nach Paravasation von Roentgenkontrastmittel. Ein Fallbericht

    Energy Technology Data Exchange (ETDEWEB)

    Ensat, F.; Babl, M.; Spies, M. [Krankenhaus Barmherzige Brueder, Klinik fuer Plastische, Hand- und wiederherstellende Chirurgie, Regensburg (Germany)

    2010-03-15

    The paravasation of radiographic contrast medium has a wide spectrum of clinical presentations, ranging from local erythema and swelling to extensive damage to the extremity affected. We report the case of a patient who developed an acute compartment syndrome of the forearm after paravenous mechanical injection of 100 ml radiographic contrast medium. After emergency fasciotomy for muscle and nerve decompression the full range of motion and sensitivity could be restored. (orig.) [German] Die Paravasation von Roentgenkontrastmittel verlaeuft klinisch zumeist harmlos, kann jedoch auch zur ausgedehnten Schaedigung der betroffenen Extremitaet fuehren. Wir berichten ueber die Ausbildung eines akuten Kompartmentsyndroms des Unterarms nach paravenoeser Druckinjektion von 100 ml Roentgenkonstrastmittel ohne vorausgegangenes Trauma. Durch eine notfallmaessige Fasziotomie kam es zur vollstaendigen Wiederherstellung von Sensibilitaet und Motorik. (orig.)

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

    Institute of Scientific and Technical Information of China (English)

    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.

  8. Abdominal radiotherapy: a major determinant of metabolic syndrome in nephroblastoma and neuroblastoma survivors

    NARCIS (Netherlands)

    Waas, M. van; Neggers, S.J.; Raat, H.; Rij, C.M. van; Pieters, R.; Heuvel-Eibrink, M.M. van den

    2012-01-01

    BACKGROUND: Reports on metabolic syndrome in nephroblastoma and neuroblastoma survivors are scarce. Aim was to evaluate the occurrence of and the contribution of treatment regimens to the metabolic syndrome. PATIENTS AND METHODS: In this prospective study 164 subjects participated (67 adult long-ter

  9. Pain symptoms and stooling patterns do not drive diagnostic costs for children with functional abdominal pain and irritable bowel syndrome in primary or tertiary care

    Science.gov (United States)

    The objectives of this study were to (1) compare the cost of medical evaluation for children with functional abdominal pain or irritable bowel syndrome brought to a pediatric gastroenterologist versus children who remained in the care of their pediatrician, (2) compare symptom characteristics for th...

  10. 股部急性间隔综合征%Acute compartment syndrome occurred in the position of thigh

    Institute of Scientific and Technical Information of China (English)

    张功林; 章鸣

    2007-01-01

    急性间隔综合征(Acute compartment syndrome,ACS)是临床上较为常见的一种骨科并发症,人们对前臂缺血性挛缩和小腿急性间隔综合征比较熟悉,但对股部急性间隔综合征的发生认识不足。已有临床研究资料表明,该症的发生呈进行性增长趋势,且有一定的死亡率。为提高对本症的认识。本文对其发病机制、诊断与治疗进行综述。

  11. The value of creatine kinase in the early diagnosis of compartment syndrome%肌酸激酶在骨筋膜室综合征早期诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    刘登胜; 张弩; 等

    2001-01-01

    目的 为早期诊断骨筋膜室综合征,降低其致残率,提供一项简便、易行的生化指标。方法 对27例骨筋膜室综合征患者分别测定血清肌酸激酶及筋膜室压力,其中15例作筋膜室切开减压,取肌肉标本进行组织学检查。结果 肌酸激酶值与肌肉组织病理变化程度一致。结论 肌酸激酶值测定可用于骨筋膜室综合征的早期诊断及评估预后。%Objective To diagnose the compartment syndrome early and decreaseits disability rate.Methods The serum creatine kinase (CK) and the compartment pressures were measured in 27 cases of compartment syndrome. Histological examination of muscle specimens were taken in 15 cases who received fasciotomy.Results The serum CK level was corresponded to the pathological changes.Conclusion CK is useful in the early diagnosis and evaluation of prognosis of compartment syndrome.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Subtypes of irritable bowel syndrome based on abdominal pain/discomfort severity and bowel pattern

    Science.gov (United States)

    Irritable bowel syndrome (IBS) has traditionally been classified by stooling pattern (e.g., diarrhea-predominant). However, other patterns of symptoms have long been recognized, e.g., pain severity. Our objective was to examine the utility of subtyping women with IBS based on pain/discomfort severit...

  14. Is intra-abdominal hypertension a missing factor that drives multiple organ dysfunction syndrome?

    Science.gov (United States)

    Kirkpatrick, Andrew W; Roberts, Derek J; De Waele, Jan; Laupland, Kevin

    2014-03-19

    In a recent issue of Critical Care, Cheng and colleagues conducted a rabbit model study that demonstrated that intra-abdominal hypertension (IAH) may damage both gut anatomy and function. With only 6 hours of IAH at 25 mmHg, these authors observed an 80% reduction in mucosal blood flow, an exponential increase in mucosal permeability, and erosion and necrosis of the jejunal villi. Such dramatic findings should remind all caring for the critically ill that IAH may severely damage the normal gut barrier functions and thus may be reasonably expected to facilitate bacterial and mediator translocation. The potential contribution of IAH as a confounding factor in the efficacy of selective decontamination of the digestive tract should be considered.

  15. [Systolic pressure, abdominal obesity and body fat, metabolic syndrome predictors in Spanish preschoolers].

    Science.gov (United States)

    Gutiérrez Hervás, Ana Isabel; Rizo Baeza, María Mercedes; Martínez Amorós, Natalia; Cortés Castell, Ernesto

    2015-05-01

    Se plantea como objetivo determinar la presencia de predictores de síndrome metabólico en niños de 2 a 7 años en relación a su estado nutricional. Método: Estudio descriptivo con análisis cuantitativo en 260 niños de 2-7 años (135 niñas y 125 niños), 66% del total censados. Se midieron parámetros antropométricos y tensión arterial y se calcularon IMC, grasa corporal según Hoffman e índice cintura-talla (ICT). Se realizaron subgrupos con Z-Score del IMC según edad y sexo (bajo peso, normopeso, sobrepeso y obesidad), según grasa corporal (normal y con exceso), ICT (normal y obesidad abdominal) y tensión sistólica (normotensos e hipertensos según edad y sexo). Se utilizó como variable principal la clasificación según Z-Score del IMC. Resultados: La prevalencia combinada de sobrepeso y obesidad fue del 27%, sin diferencias por sexo. El estado nutricional relacionó significativamente con tensión arterial, grasa corporal e índice cintura-talla. Mayor porcentaje de obesos con tensión arterial sistólica alta que de normonutridos (OR=4.1; IC95% 1.7-9.8; p.

  16. A Model for Precise and Uniform Pelvic- and Limb-Sparing Abdominal Irradiation to Study the Radiation-Induced Gastrointestinal Syndrome in Mice Using Small Animal Irradiation Systems

    Science.gov (United States)

    Brodin, N. Patrik; Velcich, Anna; Guha, Chandan

    2017-01-01

    Background and Purpose: Currently, no readily available mitigators exist for acute abdominal radiation injury. Here, we present an animal model for precise and homogenous limb-sparing abdominal irradiation (LSAIR) to study the radiation-induced gastrointestinal syndrome (RIGS). Materials and Methods: The LSAIR technique was developed using the small animal radiation research platform (SARRP) with image guidance capabilities. We delivered LSAIR at doses between 14 and 18 Gy on 8- to 10-week-old male C57BL/6 mice. Histological analysis was performed to confirm that the observed mortality was due to acute abdominal radiation injury. Results: A steep dose–response relationship was found for survival, with no deaths seen at doses below 16 Gy and 100% mortality at above 17 Gy. All deaths occurred between 6 and 10 days after irradiation, consistent with the onset of RIGS. This was further confirmed by histological analysis showing clear differences in the number of regenerative intestinal crypts between animals receiving sublethal (14 Gy) and 100% lethal (18 Gy) radiation. Conclusion: The developed LSAIR technique provides uniform dose delivery with a clear dose response, consistent with acute abdominal radiation injury on histological examination. This model can provide a useful tool for researchers investigating the development of mitigators for accidental or clinical high-dose abdominal irradiation. PMID:28203121

  17. The effects of the DASH diet education program with omega-3 fatty acid supplementation on metabolic syndrome parameters in elderly women with abdominal obesity

    OpenAIRE

    Choi, Seung-Hye; Choi-Kwon, Smi

    2014-01-01

    BACKGROUND/OBJECTIVES The purpose of this study was to investigate the overall effects of a tailored Dietary Approaches to Stop Hypertension (DASH) nutritional intervention program which included omega-3 fatty acids supplementation, on dietary self-efficacy, dietary knowledge, and dietary behaviors in Korean elderly women with abdominal obesity. Furthermore, we investigated the effects of the program on metabolic syndrome parameters including the antioxidant capacities in these subjects. SUBJ...

  18. The intestinal barrier in irritable bowel syndrome: subtype-specific effects of the systemic compartment in an in vitro model.

    Directory of Open Access Journals (Sweden)

    Samefko Ludidi

    Full Text Available Irritable bowel syndrome (IBS is a disorder with multifactorial pathophysiology. Intestinal barrier may be altered, especially in diarrhea-predominant IBS (IBS-D. Several mediators may contribute to increased intestinal permeability in IBS.We aimed to assess effects of tryptase and LPS on in vitro permeability using a 3-dimensional cell model after basolateral cell exposure. Furthermore, we assessed the extent to which these mediators in IBS plasma play a role in intestinal barrier function.Caco-2 cells were grown in extracellular matrix to develop into polarized spheroids and were exposed to tryptase (10 - 50 mU, LPS (1 - 50 ng/mL and two-fold diluted plasma samples of 7 patients with IBS-D, 7 with constipation-predominant IBS (IBS-C and 7 healthy controls (HC. Barrier function was assessed by the flux of FITC-dextran (FD4 using live cell imaging. Furthermore, plasma tryptase and LPS were determined.Tryptase (20 and 50 mU and LPS (6.25 - 50 ng/mL significantly increased Caco-2 permeability versus control (all P< 0.05. Plasma of IBS-D only showed significantly elevated median tryptase concentrations (7.1 [3.9 - 11.0] vs. 4.2 [2.2 - 7.0] vs. 4.2 [2.5 - 5.9] μg/mL; P<0.05 and LPS concentrations (3.65 [3.00 - 6.10] vs. 3.10 [2.60-3.80] vs. 2.65 [2.40 - 3.40] EU/ml; P< 0.05 vs. IBS-C and HC. Also, plasma of IBS-D increased Caco-2 permeability versus HC (0.14450 ± 0.00472 vs. 0.00021 ± 0.00003; P < 0.001, which was attenuated by selective inhibition of tryptase and LPS (P< 0.05.Basolateral exposure of spheroids to plasma of IBS-D patients resulted in a significantly increased FD4 permeation, which was partially abolished by selective inhibition of tryptase and LPS. These findings point to a role of systemic tryptase and LPS in the epithelial barrier alterations observed in patients with IBS-D.

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

    Directory of Open Access Journals (Sweden)

    Barascuk Natasha

    2011-12-01

    Full Text Available Abstract Background Abdominal aortic calcifications (AAC predict cardiovascular mortality. A new scoring model for AAC, the Morphological Atherosclerotic Calcification Distribution (MACD index may contribute with additional information to the commonly used Aortic Calcification Severity (AC24 score, when predicting 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. Methods Three hundred and eight healthy women aged 48 to 76 years, were followed for 8.3 ± 0.3 years. AAC was quantified using lumbar radiographs. Baseline data included age, weight, blood pressure, blood lipids, and glucose levels. Pearson correlation coefficients were used to test for relationships. Results At baseline and across all patients, MACD correlated with blood glucose (r2 = 0.1, P Conclusion Patterns of calcification identified by the MACD, but not the AC24 index, appear to contain useful biological information perhaps explaining part of the improved identification of risk of cardiovascular death of the MACD index. Correlations of MACD but not the AC24 with glucose levels at baseline suggest that hyperglycemia may contribute to unique patterns of calcification indicated by the MACD.

  20. Limits and advantages of abdominal ultrasonography in children with acute appendicitis syndrome

    Directory of Open Access Journals (Sweden)

    Valentina Pastore

    2014-01-01

    Full Text Available Background: Graded compression ultrasonography (US has become the most popular technique used in suspected appendicitis and in our prospective study, we have evaluated its contribution to the diagnosis of acute appendicitis during the period 2010-2013. Materials and Methods: Four hundred and eighty children underwent urgent abdominal suspected of having acute appendicitis. Patients were divided into operated groups; (220 patients and non-operated (260 patients the final diagnosis was established on histopathological findings in the first group and on the phone interview in the second one. US was the sole imaging modality in all the non-operated patients and in 203 out of 220 operated ones. Seven children in the operated group underwent CT, while a second US was performed in 10 patients. Results: Acute appendicitis was confirmed in 188 operated patients while no one in the non-operated group returned to the hospital or was operated for appendicitis. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 79%, 78%, 95%, 39% and 79%, respectively. Negative appendectomy and perforation rates were 14% and 8%. Seventeen children in the operated group required a second diagnostic imaging: 7 CTs and 10 USs. All the seven CTs were consistent with appendicitis and 6 out of 10 USs showed ecographic signs of appendicitis. Conclusion: Our results support routine US in all the children with suspected appendicitis because it helps in reducing negative appendectomy and perforation rate. Moreover, a negative US does not justify a subsequent and immediate CT because clinical re-evaluation and a second US can clarify the diagnosis.

  1. [ABDOMINAL BIOELECTRICAL IMPEDANCE ANALYSIS AND ANTHROPOMETRY FOR PREDICTING METABOLIC SYNDROME IN MIDDLE AGED MEN].

    Science.gov (United States)

    Fernández-Vázquez, Rosalía; Millán Romero, Ángel; Barbancho, Miguel Ángel; Alvero-Cruz, José Ramón

    2015-09-01

    Objetivo: la obesidad central tiene una gran relación con el síndrome metabólico. Estudiar la relación de la grasa del tronco, el índice de grasa visceral y las medidas antropométricas con el síndrome metabólico. Métodos: diseño: transversal descriptivo y correlacional. Participaron 75 varones, voluntarios, de distintas profesiones, que accedieron a un reconocimiento médico- laboral, con un rango de edad de 21 a 59 años. Mediciones de peso, talla, índice de masa corporal, perímetro abdominal, perímetro glúteo, índice cintura-cadera y grasa de tronco y nivel de grasa visceral mediante bioimpedanciometría (Tanita AB-140-ViScan) y parámetros bioquímicos: glucosa, colesterol total y triglicéridos. Así mismo, se midió la presión arterial sistólica y diastólica. Se comparan los estados de síndrome metabólico, sobrepeso y obesidad. Resultados: existen correlaciones de las medidas antropométricas con la de grasa de tronco y el nivel de grasa visceral, así como con los parámetros bioquímicos (p obesidad y síndrome metabólico. Conclusiones: la grasa de tronco y los niveles de grasa visceral son muy sensibles y específicos para la detección del síndrome metabólico y la obesidad, aunque no superan a las variables e índices antropométricos. En la condición de sobrepeso, la grasa de tronco y visceral son medidas algo más predictivas que las variables antropométricas.

  2. 小腿骨筋膜室综合征早期护理干预的疗效分析%Curative effect analysis of early nursing intervention in the treatment of shank compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    刘维; 王莹

    2016-01-01

    目的:观察早期护理干预对小腿骨筋膜室综合征的疗效.方法:对小腿骨筋膜室综合征患者12例给予早期综合护理干预.结果:所有患者的病情均得到有效控制,恢复较好,未见严重并发症的发生.结论:早期护理干预可有效促进小腿骨筋膜室综合征患者术后功能恢复,降低严重并发症的发生.%Objective:To observe the curative effect of early nursing intervention in the treatment of shank compartment syndrome. Methods:12 cases of patients with shank compartment syndrome were treated with early comprehensive nursing intervention. Results:The pathogenetic condition of all the patients were controlled effectively and recovered well,and no serious complications occurred.Conclusion:Early nursing intervention could promote the functional recovery of the patients with shank compartment syndrome effectively and reduce the occurrence of serious complications.

  3. Abdominal pain in Irritable Bowel Syndrome: a review of putative psychological, neural and neuro-immune mechanisms.

    Science.gov (United States)

    Elsenbruch, Sigrid

    2011-03-01

    Chronic abdominal pain is a common symptom of great clinical significance in several areas of medicine. In many cases no organic cause can be established resulting in the classification as functional gastrointestinal disorder. Irritable Bowel Syndrome (IBS) is the most common of these conditions and is considered an important public health problem because it can be disabling and constitutes a major social and economic burden given the lack of effective treatments. IBS aetiology is most likely multi-factorial involving biological, psychological and social factors. Visceral hyperalgesia (or hypersensitivity) and visceral hypervigilance, which could be mediated by peripheral, spinal, and/or central pathways, constitute key concepts in current research on pathophysiological mechanisms of visceral hyperalgesia. The role of central nervous system mechanisms along the "brain-gut axis" is increasingly appreciated, owing to accumulating evidence from brain imaging studies that neural processing of visceral stimuli is altered in IBS together with long-standing knowledge regarding the contribution of stress and negative emotions to symptom frequency and severity. At the same time, there is also growing evidence suggesting that peripheral immune mechanisms and disturbed neuro-immune communication could play a role in the pathophysiology of visceral hyperalgesia. This review presents recent advances in research on the pathophysiology of visceral hyperalgesia in IBS, with a focus on the role of stress and anxiety in central and peripheral response to visceral pain stimuli. Together, these findings support that in addition to lower pain thresholds displayed by a significant proportion of patients, the evaluation of pain appears to be altered in IBS. This may be attributable to affective disturbances, negative emotions in anticipation of or during visceral stimulation, and altered pain-related expectations and learning processes. Disturbed "top-down" emotional and cognitive pain

  4. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Massive Spontaneous Retroperitoneal Hemorrhage Induced by Enoxaparin and Subsequent Abdominal Compartment Syndrome Requiring Surgical Decompression: A Case Report and Literature Review

    Science.gov (United States)

    2011-08-01

    intramuscular iliopsoas- hematoma (1.7 x 1.7 and 2.2 x 2.2 cm) (Figure 1). A decision was made to continue the supportive measures after the diagnosis of...evacuation and manifests as impaired cardiac output, respiratory insufficiency, obstructive nephropathy leading to oliguria, hypotension and intestinal...grade 1 IAH with more than two end organ dysfunction even though his IAP ង mmHg. Since ACS is a clinical diagnosis supported by objective values

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

    Directory of Open Access Journals (Sweden)

    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.

  8. MRI sagittal abdominal diameter is a stronger predictor of metabolic syndrome than visceral fat area or waist circumference in a high-risk vascular cohort

    Directory of Open Access Journals (Sweden)

    Michel R Hoenig

    2010-07-01

    Full Text Available Michel R HoenigUniversity of Queensland, Brisbane, Queensland, AustraliaObjective: To determine whether sagittal abdominal diameter (SAD is associated with the metabolic syndrome independently of visceral fat area (VFA and waist circumference (WC.Methods: Forty-three high-risk vascular patients were evaluated for metabolic syndrome criteria and underwent magnetic resonance imaging (MRI to quantify SAD and VFA at the L4–L5 disc.Comparisons: 1. Baseline differences in patients with and without the metabolic syndrome 2. Forward binary logistic regression analysis of predictors of the metabolic syndrome with SAD, VFA and WC as independents 3. Correlates of SAD.Results: Patients with metabolic syndrome had greater SAD, VFA and WC than patients without the metabolic syndrome (P < 0.01. Of SAD, VFA and WC, only SAD was associated with metabolic syndrome on forward binary logistic regression; beta 0.68, Wald’s statistic 10.8 (P = 0.001 and c-statistic 0.89 (P < 0.001. A > 22.7 cm SAD threshold identified metabolic syndrome with a 91% sensitivity and 80% specificity. SAD correlated with waist circumference (r = 0.918, high-density lipoprotein-cholesterol (r = –0.363, triglyceride (r = 0.401, fasting glucose (r = 0.428 and the QUICK index of insulin sensitivity (r = –0.667 (all P < 0.05.Conclusions: MRI-measured SAD is associated with the metabolic syndrome and renders the current gold standard of VFA redundant. This measure of obesity-related cardiovascular risk requires validation and evaluation in a prospective cohort.Keywords: obesity, insulin resistance

  9. Early Diagnosis and Treatment for Compartment Syndrome in Children%儿童间隔综合征的早期诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    曾裴; 戴祥麒; 张质彬

    1996-01-01

    通过对患间隔综合征的31例患儿复查,总结如何正确作出早期诊断和治疗的经验.31例患儿中,上肢病变16例,其中9例为肱骨髁上骨折(56%),下肢病变15例,其中7例为胫腓骨骨折(40%).25例行筋膜减张术,17例获得随访,平均随访时间为28个月,14例肢体功能恢复(82%).治疗成功的关键在于早期诊断和治疗,彻底的筋膜减张是预防神经、肌肉坏死唯一有效的方法.临床诊断间隔综合征的五大要点:疼痛是最早最常见的症状,感觉障碍是很早出现而易被忽视的体征,疼痛消失和麻痹是晚期标志,被动牵拉试验阳性是手术适应证,但不能作为唯一的确诊指标.%Thirty-one cases of compartment syndrome were reviewed.In 16 cases of upper limb involvement,9 cases(56%)resulted from supracondylar fracture of the humerus.In 15 cases of lower limb involvement,7(40%)resulted from fractures of the tibia and fibula.Of them,25 cases underwent fasciotomy,17 cases were followed up for an average of 28 months.Successful results were obtained in 14 (82%).It seems that early diagnosis and treatment are very important for good prognosis.Thorough fasciotomy is the only effective method to prevent nerve and muscle necrosis.The authors suggest the significanee of 5P signs:pain is the earliest and most common symptom,paresthesia appears early but is easily neglected,paralysis and painlessness are the late signs;pain aggravated by passive extension with a definite diagnosis is an indication of operation.

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

    Energy Technology Data Exchange (ETDEWEB)

    Litwiller, Daniel V. [Mayo Clinic College of Medicine, MR Research Laboratory, Rochester, MN (United States); Amrami, Kimberly K. [Mayo Clinic, Department of Radiology, Division of Body MRI, Rochester, MN (United States); Dahm, Diane L.; Stuart, Michael J. [Mayo Clinic College of Medicine, Department of Orthopedic Surgery, Rochester, MN (United States); Smith, Jay; Laskowski, Edward R. [Mayo Clinic College of Medicine, Department of Physical Medicine and Rehabilitation, Rochester, MN (United States); Felmlee, Joel P. [Mayo Clinic College of Medicine, MR Research Laboratory, Rochester, MN (United States); Mayo Clinic, Department of Radiology, Division of Body MRI, Rochester, MN (United States)

    2007-11-15

    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

  11. Clinical study of the chronic lumbar pain induced by chronic compartment syndrome%骨筋膜室综合征致慢性腰痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    白跃宏; 欧阳颀; 郝玉洁; 刘燕; 魏智钧

    2004-01-01

    insufficient.OBJECTIVE: To explore the clinical diagnosis and management of lumbar pain induced by chronic lumbosacral compartment syndrome and relevant pathophysiologic changes of skeleton muscles (SM). DESIGN: None-randomized self-control, retrospective trial.SETTING AND PARTICIPANTS: Thirty-three patients diagnosed as with CCS suffering from lumbar pain for 2 to 42 years with a mean course of 27 years, who received treatment in the General Hospital of Beijing Command, 15 males and 18 females, aged 18 - 66 with a mean age of 42.3.METHODS: Microsurgical depression of fasciotomy(DOF) in lumbosarcal erect spinal muscle(ESM) was applied followed by waist and abdominal muscles functional exercise. A self-designed pressure-measuring needle with a lateral aperture and a micro-pressoreceptive apparatus was penetrated into the ESM at the level of L3 spinal prominence to test the ICP at rest, during exercise and 6 main after exercise. MAIN OUTCOME MEASURE: Low-back pain, walking ability, anteflexion and backward extension activity, as well as lumbosacral blood flow (LBF) measured by ultrasonic Doppler technique and intracompartment pressure (ICP) at rest, during exercise, and after exercise were observed.RESULTS: Obviously alleviated low-back pain and increased walking ability were observed after operation, lumbar anteflexion and backward extension activity increased by (15 ±0.5)° and (7±0.7)° respectively. The values of lumbosacral ICP after operation were(0.9±0.1), (21.6±1.6), and (0.9±0.1) lkPa, at rest, during exercise, and 6 minute after exercise respectively, all significantly lower than those before operation, (1.4±0.1), (24.9±1.5), and(1.8±0.2)kPa (t=2.04,2.32,3.21, P <0.05 or 0.01) . Optical microscopy showed degeneration, punctate atrophy and necrosis of ESM. Electron microscopy showed scattered disorderly arrangement of SM fibers with multiple fibrosis. Ultrasonic Doppler technique showed obviously increased LBF in SM in comparison with that before

  12. Abdominal Pain Syndrome

    Science.gov (United States)

    ... of the stomach) Pancreatitis (inflammation of the pancreas) Cholecystitis (inflammation of the gall bladder) Choledocholithiasis (passage of ... correct a problem. For example, pain due to cholecystitis (inflammation of the gall bladder) is usually treated ...

  13. Open abdomen in the treatment of intra-abdominal hypertension in patients with severe acute pancreatitis%重症急性胰腺炎的腹腔高压与腹腔开放治疗

    Institute of Scientific and Technical Information of China (English)

    李宁

    2010-01-01

    @@ 早在20世纪初期,就有学者注意到腹腔高压对患者心血管、肾脏等的功能产生不利影响.重症急性胰腺炎(severe acute pancreatitis,SAP)常导致腹腔高压,不仅限制腹式呼吸,减少机体氧供,而且对泌尿、循环、消化和中枢神经系统等产生一系列严重影响,如不及时治疗,将导致腹腔间室综合征(abdominal compartment syndrome,ACS).%Severe acute pancreatitis (SAP) can induce intra-abdominal hypertension, which has an adverse effect on the function of urinary, circulatory, digestive and neurological system, and finally leads to abdominal compartment syndrome (ACS) if patients were not timely treated. This article focuses on the close relationship between SAP and ACS, which included the definition, classification, pathogenesis of ACS and its pathophysiologic effects on other important organs. The different types and indications of surgical interventions of ACS were discussed in detail. For SAP patients complicated with ACS, urgent open abdomen is important to decrease the abdominal pressure and to prevent the incidence of multi-organ dysfunction syndrome. Complications after open abdomen, such as intestine fistula,abdominal sepsis, intestinal dysfunction and abdominal deficit,should be managed prudently.

  14. 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

    Directory of Open Access Journals (Sweden)

    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.

  15. Persistent Müllerian duct syndrome of mixed anatomical variant (combined male and female type with mixed germ cell tumor of left intra-abdominal testis

    Directory of Open Access Journals (Sweden)

    Manisha Mohapatra

    2016-01-01

    Full Text Available Persistent Müllerian duct syndrome (PMDS is a rare form of internal male pseudohermaphroditism characterized by retention of Müllerian duct derivatives in a phenotypically and karyotypically male patient. Deficiency of anti-Müllerian hormone (AMH secretion or resistance to AMH action due to defective AMH-II receptor is presumed to cause such syndrome in the majority of cases. About 158 PMDS cases have been reported so far, out of which 31 cases are associated with testicular neoplasms. Herein, we describe an interesting case of young male initially diagnosed and treated for inguinal hernia, but finally diagnosed as “PMDS of mixed anatomical variant (combined male and female type with mixed germ cell tumor of left intra-abdominal testis” comprising components of seminoma and yolk sac tumor and treated successfully.

  16. The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper.

    Science.gov (United States)

    Sartelli, Massimo; Abu-Zidan, Fikri M; Ansaloni, Luca; Bala, Miklosh; Beltrán, Marcelo A; Biffl, Walter L; Catena, Fausto; Chiara, Osvaldo; Coccolini, Federico; Coimbra, Raul; Demetrashvili, Zaza; Demetriades, Demetrios; Diaz, Jose J; Di Saverio, Salomone; Fraga, Gustavo P; Ghnnam, Wagih; Griffiths, Ewen A; Gupta, Sanjay; Hecker, Andreas; Karamarkovic, Aleksandar; Kong, Victor Y; Kafka-Ritsch, Reinhold; Kluger, Yoram; Latifi, Rifat; Leppaniemi, Ari; Lee, Jae Gil; McFarlane, Michael; Marwah, Sanjay; Moore, Frederick A; Ordonez, Carlos A; Pereira, Gerson Alves; Plaudis, Haralds; Shelat, Vishal G; Ulrych, Jan; Zachariah, Sanoop K; Zielinski, Martin D; Garcia, Maria Paula; Moore, Ernest E

    2015-01-01

    The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal. However, the OA may require multiple returns to the operating room and may be associated with significant complications, including enteroatmospheric fistulas, loss of abdominal wall domain and large hernias. Surgeons should be aware of the pathophysiology of severe intra-abdominal sepsis and always keep in mind the option of using open abdomen to be able to use it in the right patient at the right time.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    L Correa-Martín

    Full Text Available 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.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.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.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.

  19. 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

    Science.gov (United States)

    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 ...

  20. Abdominal bloating and irritable bowel syndrome like symptoms following microinstillation inhalation exposure to chemical warfare nerve agent VX in guinea pigs.

    Science.gov (United States)

    Katos, Alexandre M; Conti, Michele L; Moran, Theodore S; Gordon, Richard K; Doctor, Bhupendra P; Sciuto, Alfred M; Nambiar, Madhusoodana P

    2007-05-01

    While assessing the methylphosphonothioic acid S-(2-(bis(1-methylethyl)amino)ethyl)O-ethyl ester (VX) induced respiratory toxicity and evaluating therapeutics against lung injury, we observed that the animals were experiencing abnormal swelling in the abdominal area. Nerve agent has been known to increase salivary, nasal and gastrointestinal secretion and cause diarrhea. This study was initiated to investigate the effect of VX on the gastrointestinal tract (GI) since abdominal pathology may affect breathing and contribute to the on going respiratory toxicity. The mid-abdominal diameter and the size of the lower left abdomen was measured before and after 27.3 mg/m3 VX exposure by microinstillation and at 30 min intervals up to 2 h post-VX exposure. Both VX and saline exposed animals exhibited a decrease in circumference of the upper abdomen, although the decrease was slightly higher in VX-exposed animals up to 1 h. The waist diameter increased slightly in VX-exposed animals from 60 to 90 min post-VX exposure but was similar to saline controls. The lower left abdomen near to the cecum, 6 cm below and 2cm to the right of the end of the sternum, showed an increase in size at 30-60 min that was significantly increased at 90-120 min post-VX exposure. In addition, VX-exposed animals showed loose fecal matter compared to controls. Necropsy at 24h showed an increased small intestine twisting motility in VX-exposed animals. Body tissue AChE assay showed high inhibition in the esophagus and intestine in VX-exposed animals indicating that a significant amount of the agent is localized to the GI following microinstillation exposure. These results suggest that microinstillatipn inhalation VX exposure induces gastrointestinal disturbances similar to that of irritable bowel syndrome and bloating.

  1. Nursing of patients with bone fascia compartment syndrome after radial artery coronary artery intervention%经桡动脉冠状动脉介入术后并发骨筋膜间室综合征的护理

    Institute of Scientific and Technical Information of China (English)

    陆月兰; 孟丽华; 高文君

    2015-01-01

    目的:总结经桡动脉冠状动脉介入术后患者发生骨筋膜间室综合征的护理对策。方法对2009年1月~2014年12月经桡动脉冠状动脉介入术后并发骨筋膜间室综合征8例患者的临床资料进行回顾性分析,总结护理对策,包括密切观察病情、肿胀的观察和护理、用药护理、疼痛护理和凝血功能监测。结果所有患者出现疼痛,穿刺前臂明显肿胀、变硬,其中6例桡动脉搏动减弱,1例手指牵拉痛,1例肌力减退,1例右上肢无力,经对症治疗后缓解。结论骨筋膜间室综合征的早期观察至关重要,高度重视患者的主诉,针对并发症产生的原因及时采取有效的护理对策,争取内科保守治疗时间,可减少患者痛苦,促进患者早日康复。%Objective To explore the causes of bone fascia compartment syndrome after radial artery coronary artery intervention and sum up the nursing experience. Method The clinical data of 8 patients with bone fascia compartment syndrome after radial artery coronary artery intervention from January 2009 to December 2014 were analyzed retrospectively to summarize the nursing countermeasures, including close observation of illness, swelling and pain nursing, medication and blood and monitoring of coagulation functions. Result The forearm of all patients were painful, swollen and enlarged, 6 of them with radial pulse abating,1 with finger pulling pain, 2 with muscle decreasing. Conclusions The early observation and treatment of bone fascia compartment syndrome are critical. Great importance to the complaints of patients should be attached in view of the causes of complications so that effective nursing strategy can be taken to save time of conservative treatment, alleviate the patients'pains and promote their early recovery.

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  3. Updates on abdominal desmoid tumors

    Institute of Scientific and Technical Information of China (English)

    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.

  4. Blunt abdominal injury with rupture of giant hepatic cavernous hemangioma and laceration of the spleen.

    Science.gov (United States)

    Kang, Lung-Yun; Huang, Fong-Dee; Liu, Yuan-Yuarn

    2015-02-01

    A 41-year-old woman with blunt abdominal trauma due to a motor vehicle accident presented to our emergency department. The patient had a history of a giant hepatic cavernous hemangioma. Emergency exploratory laparotomy was performed for suspected intra-abdominal bleeding with abdominal compartment syndrome, and more than 4 liters of blood and blood clots were removed. An active bleeding laceration (5 cm) of a hepatic cavernous hemangioma was detected in segment III of the liver. The bleeding was controlled by sutures, Teflon patches and tamponade. The abdomen was closed temporarily using the vacuum-assisted method. Because of the presence of persistent fresh blood through abdominal drainage at a rate of >1 L/h, splenectomy was performed to control the bleeding again by sutures and Teflon patches. Finally, the abdomen was closed using a biologic mesh. The patient was discharged home 30 days after trauma. Bleeding of trauma-caused hepatic hemangioma is rare, but splenic injury due to blunt abdominal trauma is common. An in-depth investigation is necessary to avoid second intervention.

  5. Abdominal pain

    Science.gov (United States)

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is does not always reflect the seriousness ...

  6. Abdominal actinomycosis.

    Science.gov (United States)

    Wagenlehner, F M E; Mohren, B; Naber, K G; Männl, H F K

    2003-08-01

    Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.

  7. The myofascial compartments of the foot: a cadaver study.

    Science.gov (United States)

    Ling, Z X; Kumar, V P

    2008-08-01

    Compartment syndrome of the foot requires urgent surgical treatment. Currently, there is still no agreement on the number and location of the myofascial compartments of the foot. The aim of this cadaver study was to provide an anatomical basis for surgical decompression in the event of compartment syndrome. We found that there were three tough vertical fascial septae that extended from the hindfoot to the midfoot on the plantar aspect of the foot. These septae separated the posterior half of the foot into three compartments. The medial compartment containing the abductor hallucis was surrounded medially by skin and subcutaneous fat and laterally by the medial septum. The intermediate compartment, containing the flexor digitorum brevis and the quadratus plantae more deeply, was surrounded by the medial septum medially, the intermediate septum laterally and the main plantar aponeurosis on its plantar aspect. The lateral compartment containing the abductor digiti minimi was surrounded medially by the intermediate septum, laterally by the lateral septum and on its plantar aspect by the lateral band of the main plantar aponeurosis. No distinct myofascial compartments exist in the forefoot. Based on our findings, in theory, fasciotomy of the hindfoot compartments through a modified medial incision would be sufficient to decompress the foot.

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

    Science.gov (United States)

    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...

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

    NARCIS (Netherlands)

    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

  10. Psoas compartment block.

    Science.gov (United States)

    Brooks, D M

    2000-05-01

    The psoas compartment acts as a conduit for the nerve roots of the lumbar plexus. Originating at approximately the 12th thoracic vertebrae, this potential compartment continues on caudally, bordered posterolaterally by fascia of the quadratus lumborum and iliacus muscles, medially by the fascia of the psoas major muscle, and anteriorly by the transversalis fascia. This natural "gutter" acts as a repository for local anesthetic agents and provides an excellent method of unilateral anterior lower extremity anesthesia. After elicitation of a motor evoked response in the muscles of the anterior thigh, 30 to 40 milliliters of local anesthetic is incrementally injected into the compartment. Spread of the anesthetic to all roots of the plexus occurs in 15 to 20 minutes. Profound sensory and motor blockade can be achieved providing surgical anesthesia as well as long duration postoperative pain relief.

  11. Angiotensin II and 1-7 during aging in Metabolic Syndrome rats. Expression of AT1, AT2 and Mas receptors in abdominal white adipose tissue.

    Science.gov (United States)

    Rubio-Ruíz, M E; Del Valle-Mondragón, L; Castrejón-Tellez, V; Carreón-Torres, E; Díaz-Díaz, E; Guarner-Lans, V

    2014-07-01

    Renin-Angiotensin System (RAS) plays an important role in the development of Metabolic Syndrome (MS) and in aging. Angiotensin 1-7 (Ang 1-7) has opposite effects to Ang II. All of the components of RAS are expressed locally in adipose tissue and there is over-activation of adipose RAS in obesity and hypertension. We determined serum and abdominal adipose tissue Ang II and Ang 1-7 in control and MS rats during aging and the expression of AT1, AT2 and Mas in white adipose tissue. MS was induced by sucrose ingestion during 6, 12 and 18 months. During aging, an increase in body weight, abdominal fat and dyslipidemia were found but increases in aging MS rats were higher. Control and MS concentrations of serum Ang II from 6-month old rats were similar. Aging did not modify Ang II seric concentration in control rats but decreased it in MS rats. Ang II levels increased in WAT from both groups of rats. Serum and adipose tissue Ang 1-7 increased during aging in MS rats. Western blot analysis revealed that AT1 expression increased in the control group during aging while AT2 and Mas remained unchanged. In MS rats, AT1 and AT2 expression decreased significantly in aged rats. The high concentration of Ang 1-7 and adiponectin in old MS rats might be associated to an increased expression of PPAR-γ. PPAR-γ was increased in adipose tissue from MS rats. It decreased with aging in control rats and showed no changes during aging in MS rats. Ang 1-7/Mas axis was the predominant pathway in WAT from old MS animals and could represent a potential target for therapeutical strategies in the treatment of MS during aging.

  12. Excesso de peso e gordura abdominal para a síndrome metabólica em nipo-brasileiros Weight excess and abdominal fat in the metabolic syndrome among Japanese-Brazilians

    Directory of Open Access Journals (Sweden)

    Daniel D G Lerario

    2002-02-01

    Full Text Available OBJETIVO: A obesidade, especialmente de distribuição abdominal, associa-se a fatores de risco cardiovasculares como a dislipidemia, a hipertensão arterial (HA e o diabetes mellitus (DM. A importância desses fatores em nipo-brasileiros foi previamente demonstrada, apesar de a obesidade não ser característica marcante dos migrantes japoneses. Realizou-se estudo com o objetivo de avaliar a prevalência de excesso de peso e a adiposidade central (AC em nipo-brasileiros e suas relações com distúrbios metabólicos. MÉTODOS: A amostra incluiu 530 nipo-brasileiros (40-79 anos de primeira e segunda gerações, submetidos a medidas antropométricas de pressão arterial, perfil lipídico e teste oral de tolerância à glicose. A prevalência (por ponto e intervalo de confiança de excesso de peso foi calculada pelo valor de corte >26,4 kg/m². O diagnóstico de AC foi baseado na razão entre as circunferências da cintura e do quadril (RCQ, sendo que valores > ou = 0,85 e > ou = 0,95, para mulheres e homens, respectivamente, firmavam esse diagnóstico. RESULTADOS: A prevalência de excesso de peso foi de 22,4% (IC95%-- 20,6-28,1, e a de AC, de 67,0% (IC95% -- 63,1-70,9. Além de maiores prevalências de DM, HA e dislipidemia, estratificando-se pelo índice de massa corporal (IMC e RCQ, indivíduos com excesso de peso e adiposidade central apresentaram pior perfil metabólico: a pressão arterial foi significantemente maior naqueles com excesso de peso, sem e com AC; indivíduos com AC apresentaram maiores índices de glicemia, triglicerídeos, colesterol total e LDL e menor HDL quando comparados aos sem excesso de peso e sem AC; a insulinemia de jejum foi significantemente maior em indivíduos com excesso de peso (sem e com AC do que naqueles sem excesso de peso e sem AC. CONCLUSÃO: A comparação de subgrupos com e sem adiposidade central foi compatível com a hipótese de que a deposição abdominal de gordura representa fator de risco para

  13. Abdominal Sepsis.

    Science.gov (United States)

    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.

  14. Damage control surgery for severe thoracic and abdominal injuries

    Institute of Scientific and Technical Information of China (English)

    HUANG Xian-kai; ZHU Yu-jun; ZHANG Lian-yang

    2007-01-01

    Objective: To investigate the application of damage control surgery in treatment of patients with severe thoracic and abdominal injuries.Methods: A retrospective study was done on 37 patients with severe thoracic and abdominal injuries who underwent damage control surgery from January 2000 to October 2006 in our department. There were 8 cases of polytrauma ( with thoracic injury most commonly seen), 21 of polytrauma (with abdominal injury most commonly seen) and 8 of single abdominal trauma. Main organ damage included smashed hepatic injuries in 17 cases,posterior hepatic veins injuries in 8, pancreaticoduodenal injuries in 7, epidural or subdural hemorrhage in 4,contusion and laceration of brain in 5, severe lung and bronchus injuries in 4, pelvis and one smashed lower limb wound in 3 and pelvic fractures and retroperitoneal hemorrhage in 6. Injury severity score (ISS) was 28-45 scores (38.4 scores on average), abbreviated injury scale (ALS) ≥ 4.13. The patients underwent arteriography and arterial embolization including arteria hepatica embolization in 4 patients, arteria renalis embolization in 2 and pelvic arteria retroperitoneal embolization in 7. Once abbreviated operation finished, the patients were sent to ICU for resuscitation. Twenty-four cases underwent definitive operation within 48 hours after initial operation, 5 underwent definitive operation within 72 hours after initial operation, 2 cases underwent definitive operation postponed to 96 hours after initial operation for secondary operation to control bleeding because of abdominal cavity hemorrhea.Two cases underwent urgent laparotomy and decompression because of abdominal compartment syndrome and 2 cases underwent secondary operation because of intestinal fistulae (1 case of small intestinal fistula and 1 colon fistula) and gangrene of gallbladder.Results: A total of 28 patients survived, with a survival rate of 75.68%, and 9 died (4 died within 24 hours and 5 died 3-9 days after injury). The

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

    DEFF Research Database (Denmark)

    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....... At baseline and across all patients, MACD correlated with blood glucose (r2 = 0.1, Prisk factors (p .... Three hundred and eight healthy women aged 48 to 76 years, were followed for 8.3 ± 0.3 years. AAC was quantified using lumbar radiographs. Baseline data included age, weight, blood pressure, blood lipids, and glucose levels. Pearson correlation coefficients were used to test for relationships...

  16. Numerical modelling of crural fascia mechanical interaction with muscular compartments.

    Science.gov (United States)

    Pavan, Piero G; Pachera, Paola; Natali, Arturo N

    2015-05-01

    The interaction of the crural fascia with muscular compartments and surrounding tissues can be at the origin of different pathologies, such as compartment syndrome. This pathology consists in the onset of excessive intracompartmental pressure, which can have serious consequences for the patient, compromising blood circulation. The investigation of compartment syndrome etiology also takes into account the alteration of crural fascia mechanical properties as a cause of the syndrome, where the fascial stiffening would result in the rise of intracompartmental pressure. This work presents a computational approach toward evaluating some biomechanical aspects of the problem, within the context of a more global viewpoint. Finite element analyses of the interaction phenomena of the crural fascia with adjacent regions are reported here. This study includes the effects of a fascial stiffness increase along the proximal-distal direction and their possible clinical implications. Furthermore, the relationship between different pre-strain levels of the crural fascia in the proximal-distal direction and the rise of internal pressure in muscular compartments are considered. The numerical analyses can clarify which aspects could be directly implied in the rise of compartment syndrome, leading to greater insight into muscle-fascia mechanical phenomena, as well as promoting experimental investigation and clinical analysis of the syndrome.

  17. Abdominal Aortic Aneurysm (AAA)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... an abdominal aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. A prospective, controlled evaluation of the abdominal reapproximation anchor abdominal wall closure system in combination with VAC therapy compared with VAC alone in the management of an open abdomen.

    Science.gov (United States)

    Long, Kristin L; Hamilton, David A; Davenport, Daniel L; Bernard, Andrew C; Kearney, Paul A; Chang, Phillip K

    2014-06-01

    Dramatic increases in damage control and decompressive laparotomies and a significant increase in patients with open abdominal cavities have resulted in numerous techniques to facilitate fascial closure. We hypothesized addition of the abdominal reapproximation anchor system (ABRA) to the KCI Abdominal Wound Vac™ (VAC) or KCI ABThera™ would increase successful primary closure rates and reduce operative costs. Fourteen patients with open abdomens were prospectively randomized into a control group using VAC alone (control) or a study group using VAC plus ABRA (VAC-ABRA). All patients underwent regular VAC changes; patients receiving VAC-ABRA also underwent concomitant daily elastomer adjustment of the ABRA system. Primary end points included abdominal closure, number of operating room (OR) visits, and OR time use. Eight patients were included in the VAC-ABRA group and six patients in the control group. Primary closure rates between groups were not statistically different; however, the number of trips to the OR and OR time use were different. Despite higher Acute Physiology and Chronic Health Evaluation II scores, larger starting wound size, and higher rates of abdominal compartment syndrome, closure rates in the VAC-ABRA group were similar to VAC alone. Importantly, however, fewer OR trips and less OR time were required for the VAC-ABRA group.

  20. Abdominal migraine in childhood: a review

    Directory of Open Access Journals (Sweden)

    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

  1. 小儿肱骨远端骨折严重合并症——骨筋膜室综合征%A Serious Complication of Fracture of Distal Humerus in Children-Acute Osteofaseial Compartment Syndrome

    Institute of Scientific and Technical Information of China (English)

    刘兴炎; 葛宝丰; 文益民; 甄平; 石骥

    1995-01-01

    32例小儿前臂严重骨筋膜室综合征中,除4例为骨折直接合并肱动脉程度不同损伤继发外,余下之28例均为医源性处理不当所致.基于儿童上肢功能重建的特点,有必要选择外科综合治疗.早期采用骨筋膜室彻底减压,尤其强调早期恢复神经干的血运.对5例晚期缺血性挛缩处理,采用游离吻合血管神经的腓肠肌内侧头肌皮瓣重建手及前臂功能,随访1年以上结果满意.%Thirty-two cases of acute osteofascial compartment syndrome complicated to the distal humerus fracture in chileren were treated.Of them,28 were iatrogenic lesion,others were resulted from fracture of distal humerus complicated by brachial artery injury.The reasons of iatrogenic lesion were discussed in the paper.To protect the residual function of the upper extremity,surgery is essential,In acute stage,early decompression is necessary,including release of the fibrous adhesions around blood vessels,nerves and muscles,in order to improve the blood supply of the nerves.For late sequelae,e.g.ischemic constracture of the forearm,free vascularized medial gastrocnemius muscular flap with neurovascular microsurgical anastomosis was performed.Cases follow up for more than one year showed satisfactory result.

  2. Fitz-Hugh-Curtis syndrome: abdominal pain in women of 26 years old Síndrome de Fitz-Hugh-Curtis: dolor abdominal en mujer de 26 años

    OpenAIRE

    Liseth Rivero-Sánchez; Elsa María López-Soriano; Luisa Guarner-Aguilar

    2011-01-01

    Fitz-Hugh-Curtis syndrome is an inflammation of the liver capsule as a complication of pelvic inflammatory disease, whose most common etiologic agent is the C. trachomatis. The acute phase of the Fitz-Hugh-Curtis syndrome may present itself with pain in right upper abdomen, commonly confused with other hepatobiliary and gastrointestinal tract diseases. Definitive diagnosis is now possible with non-invasive techniques such as ultrasound, computed tomography, as well as techniques to isolate th...

  3. Lower extremity compartment sindrome following coronary artery bypass.

    Science.gov (United States)

    Papas, T T; Mikroulis, D; Papanas, N; Lazarides, M K; Bougioukas, G

    2007-04-01

    Compartment syndrome is a constellation of symptoms and signs associated with abnormally elevated tissue pressure in the skeletal muscle of the extremities. It is manifested in anatomic locations where muscles are enveloped in fasciae. The case of a lower extremity compartment syndrome in a 71-year-old male patient who underwent coronary artery bypass grafting (CABG) and simultaneous aortic valve surgery is reported. Preoperative evaluation revealed severe peripheral vascular disease. The patient underwent triple CABG using the left internal thoracic artery and two vein grafts. The right great saphenous vein was used for these vein grafts. The aortic valve was replaced with a biologic prosthesis. On postoperative day 1, the patient complained of pain and oedema in the right calf. The next day, symptoms worsened, with marked sensory loss, motor weakness and foot drop in the affected limb. Triplex ultrasonography excluded deep vein thrombosis. Compartment syndrome was diagnosed and successfully managed by fasciotomy. This case illustrates that compartment syndrome may, although rarely, be a complication of CABG.

  4. Effects of intra-abdominal pressure on adrenal gland function and morphology in rats.

    Science.gov (United States)

    Akkapulu, Nezih; Tirnaksiz, Mehmet Bulent; Kulac, Ibrahim; Tezel, Gaye Guler; Hayran, Mutlu; Dogrul, Ahmet Bulent; Cetinkaya, Erdinc; Yorganci, Kaya

    2015-01-01

    Intra-abdominal hypertension and abdominal compartment syndrome (IAH/ACS) are life-threatening conditions and caused by several clinical status. Although there is insufficient data regarding its effects on adrenal glands. This study aimed to identify whether elevated intra-abdominal pressure (IAP) caused any alteration on the morphology and function of adrenal glands in a rat model. Twenty four Sprague-Dawley male rats were included in the study. Animals were allocated into 4 groups. IAP was elevated to 15 mmHg for one hour and four hours in group 2 and 4. Group 1 and 3 were sham groups. Blood samples were taken for the assessment of plasma adrenaline, noradrenaline, and corticosterone levels and adrenalectomies were performed to evaluate apoptosis. Blood adrenaline, noradrenaline and corticosterone levels were significantly higher in the study groups compared with the sham groups. However, there were no significant changes in apoptotic index scores in the study groups as compared to sham groups. These results support that increased IAH leads to discharge of catecholamine and corticosterone from the adrenal glands. Failure to demonstrate similar changes in apoptotic index score may be concluded as apoptosis is not a leading pathway for impairment of adrenal glands during IAH period.

  5. Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Khan Shehtaj

    2010-01-01

    Full Text Available Background : Studies have documented the impact of intra-abdominal hypertension (IAH on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS. Materials and Methods : The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes. Results : At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1. IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001. Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%. Conclusions : IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Circunferência abdominal como preditor de evolução em 30 dias na síndrome coronariana aguda Circunferencia abdominal como predictor de evolución en 30 días en el Síndrome Coronario Agudo Abdominal circumference as a predictor of 30-day outcome in acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Priscilla Azambuja Lopes de Souza

    2011-05-01

    respondieron a un cuestionario y se midió posteriormente la CA. El análisis estadístico se realizó con SPSS 17.0, mediante la prueba de Chi-cuadrado para variables categóricas y prueba t de Student para las variables numéricas, con un nivel de significación de p BACKGROUND: Abdominal circumference (WC is the measure that correlates most closely with the risk factors and death from cardiovascular disease. However, the impact of obesity on the prognosis of patients with cardiovascular disease remains controversial and requires further clarification. OBJECTIVE: To evaluate WA as a predictor of 30-day outcome in patients who were hospitalized with acute coronary syndrome (ACS, in a referral hospital for the treatment of cardiovascular diseases. METHODS: Contemporary cohort 267 patients who were hospitalized for ACS and who were followed for 30 days after discharge, taking into account the major cardiovascular events - MACE - (death, reinfarction, rehospitalization for coronary artery bypass grafting procedures. In the first 24 hours of admission, patients answered a questionnaire and were subsequently measured for WC. The statistical analysis was performed with SPSS 17.0, using the chi-square test for categorical variables and Student t test for numerical variables, with significance level of p < 0.05. The variables that had p < 0.10 in the bivariate analysis were included in a logistic regression model to evaluate the WC role as an independent predictor of MACE. RESULTS: After multivariate analysis, only the female gender (OR = 8.86; 95% CI: 4.55-17. 10, p < 0.00, hypertension (OR = 2.06; 95% CI: 1.10-3.87; p = 0.02 and family history of ischemic heart disease (OR = 2.10; 95% CI: 1.17-3.74; p = 0.01 remained associated with the MACE. CONCLUSION: In our study, the modified AC was not associated with increased incidence of MACE over the 30 days of follow-up.

  8. 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

    Directory of Open Access Journals (Sweden)

    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

  9. 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

    Science.gov (United States)

    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...

  10. 腹针治疗博彩从业人员痹证相关性失眠的临床分析%Clinical Analysis of Abdominal Acupuncture Treating Bi-syndrome Related Insomnia of Casino Employees

    Institute of Scientific and Technical Information of China (English)

    奎瑜; 赵静; 梁建卫; 陈秀华; 王聪; 邓忠明; 李平稳

    2014-01-01

    Objective:To observe the effectiveness of abdominal acupuncture treating insomnia related Bi -syndrome of casino employees in Macao.Methods:A randomized controlled trial was conducted .Seventy seven patients in accordance with the diagnosis criteria were randomly divided into the treatment group and the control group .Patients of the treatment group received abdominal acupuncture and normal acupuncture was given to patients in the control group .Self-Rating Scale of Sleep(SRSS) and Visual analogue scale (VAS) were applied for evaluating the effectiveness in sleeping and Bi-syndrome.Results: There were significant differences in SRSS and VAS scores after treatment between the two groups (P<0.05).The total effective rate of treatment group was 89.47% and that of control group was 71.79%.There was significant difference in total effective rate between two groups (P<0.05).Conclusion: The effective-ness of abdominal acupuncture is superior to the normal body acupuncture in treating insomnia related Bi -syndrome of casino employees . It is worthy of popularization and application .%目的:探讨腹针对博彩从业人员痹证相关性失眠的治疗效果。方法:在博彩业从业人员中,选取77例痹证相关性失眠患者,随机分为2组,治疗组给予腹针治疗,对照组给予常规针刺治疗。采用睡眠状况自评量表( Self -Rating Scale of Sleep , SRSS)、视觉模拟量表( Visual Analogue Scale ,VAS)作为评价工具,分别评测睡眠状况和疼痛程度,应用积分减分法进行分析。结果:2组治疗后SRSS和VAS评分均下降,组间差异有统计学意义(P<0.05),治疗组总有效率为89.47%,对照组总有效率为71.79%,差异有统计学意义( P<0.05)。结论:腹针是治疗博彩从业人员痹证相关性失眠的有效方法,值得推广。

  11. Dual-Compartment Inflatable Suitlock

    Science.gov (United States)

    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

  12. Fitz-Hugh-Curtis syndrome: abdominal pain in women of 26 years old Síndrome de Fitz-Hugh-Curtis: dolor abdominal en mujer de 26 años

    Directory of Open Access Journals (Sweden)

    Liseth Rivero-Sánchez

    2011-10-01

    Full Text Available Fitz-Hugh-Curtis syndrome is an inflammation of the liver capsule as a complication of pelvic inflammatory disease, whose most common etiologic agent is the C. trachomatis. The acute phase of the Fitz-Hugh-Curtis syndrome may present itself with pain in right upper abdomen, commonly confused with other hepatobiliary and gastrointestinal tract diseases. Definitive diagnosis is now possible with non-invasive techniques such as ultrasound, computed tomography, as well as techniques to isolate the responsible germ, available in most centers.El síndrome de Fitz-Hugh-Curtis es una inflamación de la cápsula hepática, como complicación de una enfermedad inflamatoria pélvica, cuyo agente etiológico más frecuente es la C. trachomatis. La fase aguda del síndrome de Fitz-Hugh-Curtis puede presentarse con dolor en cuadrante superior derecho del abdomen, confundiéndose comúnmente con otras enfermedades hepatobiliares y del tracto gastrointestinal. El diagnóstico definitivo es posible hoy en día por técnicas no invasivas como ecografía, tomografía computarizada, además de técnicas para el aislamiento del germen responsable disponibles en la mayoría de los centros.

  13. Cushing’s Syndrome Secondary to isolated Micronodular Adrenocortical Disease (iMAD) associated with Rapid Onset Weight Gain and Negative Abdominal MRI Findings in a 3 year old Male

    Science.gov (United States)

    Henry, Rohan K.; Keil, Margaret F.; Stratakis, Constantine A.; Fechner, Patricia Y.

    2011-01-01

    Cushing’s syndrome (CS) is uncommon in childhood. CS may be either dependent or independent of adrenocorticotrophic hormone (ACTH). ACTH independent micronodular adrenocortical (MAD) disease may present in the second to third decade of life or between ages 2–3years. It may occur in isolation, or as a part of the Carney complex and it represents an elusive entity to diagnose. We present a 3 year 7 month old boy with isolated MAD (iMAD). Abdominal CT revealed prominent mildly lobulated anteromedial margin of adrenals with nodular appearance. Cardiac echo, thyroid and testicular ultrasounds performed as a work up for Carney complex were normal. Bilateral adrenalectomy confirmed MAD as the cause of CS. We present the history’ and identification of a unique case of iMAD. PMID:20662336

  14. Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy

    Directory of Open Access Journals (Sweden)

    Creticus P. Marak

    2013-01-01

    Full Text Available Ovarian hyperstimulation syndrome (OHSS is an iatrogenic complication of controlled ovarian hyperstimulation (COH protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ovaries, thereby causing a generalized capillary leak and acute shift of protein-rich fluid from the intravascular compartment into the third space. This may lead to the development of ascites, pleural effusions, pericardial effusion, anasarca, intravascular volume depletion, hemoconcentration, oliguria, hypoalbuminemia and hypoproteinemia, electrolyte imbalances, acute renal failure, abdominal compartment syndrome, thromboembolic events, and adult respiratory distress syndrome. The only effective treatment available is prevention of the syndrome from developing by individualizing the stimulation protocol, especially in high-risk patients. Once the syndrome develops, the management is mainly supportive. Oliguria and some degree of acute renal failure commonly develop in patients with moderate to severe OHSS and are usually due to prerenal causes. Acute renal failure (ARF secondary to obstructive uropathy is rare. Here we report a case of severe, life-threatening OHSS resulting in ARF secondary to obstructive uropathy.

  15. Ovarian hyperstimulation syndrome as an etiology of obstructive uropathy.

    Science.gov (United States)

    Marak, Creticus P; Chopra, Amit; Alappan, Narendrakumar; Ponea, Ana M; Guddati, Achuta K

    2013-01-01

    Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian hyperstimulation (COH) protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ovaries, thereby causing a generalized capillary leak and acute shift of protein-rich fluid from the intravascular compartment into the third space. This may lead to the development of ascites, pleural effusions, pericardial effusion, anasarca, intravascular volume depletion, hemoconcentration, oliguria, hypoalbuminemia and hypoproteinemia, electrolyte imbalances, acute renal failure, abdominal compartment syndrome, thromboembolic events, and adult respiratory distress syndrome. The only effective treatment available is prevention of the syndrome from developing by individualizing the stimulation protocol, especially in high-risk patients. Once the syndrome develops, the management is mainly supportive. Oliguria and some degree of acute renal failure commonly develop in patients with moderate to severe OHSS and are usually due to prerenal causes. Acute renal failure (ARF) secondary to obstructive uropathy is rare. Here we report a case of severe, life-threatening OHSS resulting in ARF secondary to obstructive uropathy.

  16. Management of Abdominal Wounds in Thermally Injured Patients

    Science.gov (United States)

    1982-01-01

    Acute inflammatory disease 5 Superior mesenteric artery syndrome 4 Biliary tract disease 4 surface in the patients with abdominal burns, and only...ity of these critically ill patients were equally affected by polypropylene was used for fascial closure, the wound ileus , sepsis, abdominal distention

  17. Abdominal radiation - discharge

    Science.gov (United States)

    Radiation - abdomen - discharge; Cancer - abdominal radiation; Lymphoma - abdominal radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after radiation treatment starts, you might notice changes ...

  18. Abdominal aortic aneurysm

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000162.htm Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  19. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...

  20. [Pathogenetic aspects of intra-abdominal hypertension in patients with abdominal sepsis].

    Science.gov (United States)

    Veliev, N A; Gasanova, D N

    2011-09-01

    The authors had offered the original estimated system with the points calculation, basing on analysis of the examination and treatment results in 150 patients, suffering abdominal sepsis. The system, alike others, includes not only determination of the inflammation factors and indices of endotoxicosis, but as well as those, concerning intraabdominal pressure, the anterior abdominal wall rigidity and the tissues elasticity. Among the important indices, needed to determine, were considered those, which categorize the syndrome of intraabdominal, intrathoracic and microregional hypertension as well as the mechanisms of endotoxicosis pathogenesis. The authors recommend to use the indices of pathological consequences of this two factors while doing assessment of the abdominal sepsis severity.

  1. Extra-Abdominal Desmoid Tumors Associated with Familial Adenomatous Polyposis

    Directory of Open Access Journals (Sweden)

    George T. Calvert

    2012-01-01

    Full Text Available Extra-abdominal desmoid tumors are a significant cause of morbidity in patients with familial adenomatous polyposis syndrome. Understanding of the basic biology and natural history of these tumors has increased substantially over the past decade. Accordingly, medical and surgical management of desmoid tumors has also evolved. This paper analyzes recent evidence pertaining to the epidemiology, molecular biology, histopathology, screening, and treatment of extra-abdominal desmoid tumors associated with familial adenomatous polyposis syndrome.

  2. Post trauma abdominal cocoon.

    Science.gov (United States)

    Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev

    2015-01-01

    Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  3. 中西医结合在重症骨筋膜室综合征围手术期的应用%Application of the integration of traditional and western medicine for serious osteofascial compartment syndrome during the perioperation

    Institute of Scientific and Technical Information of China (English)

    任杰; 赵波; 张威

    2005-01-01

    我院自1997年3月-2002年10月共收治重症骨筋膜室综合(osteofascial compartment syndrome.以下简称OCS)病人36例。均采取切开筋膜减压,围手术期中西医结合治疗,疗效满意。

  4. Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias: Experience From the Cambridge Plastic Surgery Department

    Science.gov (United States)

    Adekunle, Shola; Pantelides, Nicholas M.; Hall, Nigel R.; Praseedom, Raaj; Malata, Charles M.

    2013-01-01

    Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). Conclusions: The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects. PMID:24058718

  5. Abdominal epilepsy in chronic recurrent abdominal pain

    Directory of Open Access Journals (Sweden)

    V Y Kshirsagar

    2012-01-01

    Full Text Available Background: Abdominal epilepsy (AE is an uncommon cause for chronic recurrent abdominal pain in children and adults. It is characterized by paroxysmal episode of abdominal pain, diverse abdominal complaints, definite electroencephalogram (EEG abnormalities and favorable response to the introduction of anti-epileptic drugs (AED. We studied 150 children with chronic recurrent abdominal pain and after exclusion of more common etiologies for the presenting complaints; workup proceeded with an EEG. We found 111 (74% children with an abnormal EEG and 39 (26% children with normal EEG. All children were subjected to AED (Oxcarbazepine and 139 (92% children responded to AED out of which 111 (74% children had an abnormal EEG and 27 (18% had a normal EEG. On further follow-up the patients were symptom free, which helped us to confirm the clinical diagnosis. Context: Recurrent chronic abdominal pain is a common problem encountered by pediatricians. Variety of investigations are done to come to a diagnosis but a cause is rarely found. In such children diagnosis of AE should be considered and an EEG will confirm the diagnosis and treated with AED. Aims: To find the incidence of AE in children presenting with chronic recurrent abdominal pain and to correlate EEG findings and their clinical response to empirical AEDs in both cases and control. Settings and Design: Krishna Institute of Medical Sciences University, Karad, Maharashtra, India. Prospective analytical study. Materials and Methods: A total of 150 children with chronic recurrent abdominal pain were studied by investigations to rule out common causes of abdominal pain and an EEG. All children were then started with AED oxycarbamezepine and their response to the treatment was noted. Results: 111 (74% of the total 150 children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56% were females and 36 (32.43% were male, majority of children were in the age of group of 9

  6. Recurrent abdominal pain: when an epileptic seizure should be suspected?

    Directory of Open Access Journals (Sweden)

    Franzon Renata C.

    2002-01-01

    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.

  7. Post trauma abdominal cocoon

    Directory of Open Access Journals (Sweden)

    Supreet Kaur

    2015-01-01

    Full Text Available Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  8. 冰敷预防高能量胫骨平台骨折后骨筋膜室综合征效果观察%Observation on the effect of ice compress to prevent patients with high-energy fracture of tibial plateau from osteofascial compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    姚菊英; 罗凯燕

    2008-01-01

    @@ 随着交通事故的日益增加,高能量胫骨平台骨折有逐年增多的趋势,因其常伴有周围软组织的广泛损伤,故易并发骨筋膜室综合征(osteofascial compartment syndrome,OCS),从而影响骨折的治疗和关节功能的恢复.为预防OCS的发生,2003年10月-2007年10月我科对闭合性高能量胫骨平台骨折病人,早期在常规处理的基础上采用自制冰袋冷敷,有效预防OCS的发生.现报道如下.

  9. Correlation between absence of bone remodeling compartment canopies, reversal phase arrest, and deficient bone formation in post-menopausal osteoporosis

    DEFF Research Database (Denmark)

    Levin Andersen, Thomas; Hauge, Ellen M; Rolighed, Lars;

    2014-01-01

    Bone remodeling compartments (BRCs) were recently recognized to be present in patients with primary hyperparathyroidism and critical for bone reconstruction in multiple myeloma and endogenous Cushing's syndrome. The BRCs are outlined by a cellular canopy separating the bone remodeling events...

  10. Relação entre obesidade e síndrome metabólica em adolescentes de 10 a 14 anos com obesidade abdominal = The relationship between obesity and metabolic syndrome in adolescents between ages 10 and 14, with abdominal obesity

    Directory of Open Access Journals (Sweden)

    Cristina Gomes de Oliveira Teixeira

    2009-04-01

    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 comobesidade 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. Osresultados 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

  11. [What do general, abdominal and vascular surgeons need to know on plastic surgery - aspects of plastic surgery in the field of general, abdominal and vascular surgery].

    Science.gov (United States)

    Damert, H G; Altmann, S; Stübs, P; Infanger, M; Meyer, F

    2015-02-01

    There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options.

  12. 浅析《内经》“诸胀腹大,皆属于热”的临床意义%Analysis of the Clinical Significance of "All Syndromes Characterize d by Abdominal Disten-sion Which Sounds Like a Drum When Palpated are Associated with Heat"in Huangdi Nei-jing

    Institute of Scientific and Technical Information of China (English)

    石卉琴; 郑红斌

    2015-01-01

    This paper analyzes "all syndromes characterized by abdominal distension which sounds like a drum when palpated are asso-ciated with heat"from Huangdi Neijing, and suggests that in clinical practice when treating distension and abdominal distension syn-drome, we need to pay attention to the pathogenesis belong to hot, contacting with the clinical case to explore clinical application, which reflects that theoretical research of Internal Classic for clinical guiding function.%分析了《内经》“诸胀腹大,皆属于热”的条文内涵,认为在临床辨治胀病和腹胀大病证时要重视因热致患的病机变化,结合临证验案探讨其临证运用,体现了内经理论研究对临床的指导作用。

  13. Novel orally available salvinorin A analog PR-38 inhibits gastrointestinal motility and reduces abdominal pain in mouse models mimicking irritable bowel syndrome.

    Science.gov (United States)

    Sałaga, M; Polepally, P R; Sobczak, M; Grzywacz, D; Kamysz, W; Sibaev, A; Storr, M; Do Rego, J C; Zjawiony, J K; Fichna, J

    2014-07-01

    The opioid and cannabinoid systems play a crucial role in multiple physiological processes in the central nervous system and in the periphery. Selective opioid as well as cannabinoid (CB) receptor agonists exert a potent inhibitory action on gastrointestinal (GI) motility and pain. In this study, we examined (in vitro and in vivo) whether PR-38 (2-O-cinnamoylsalvinorin B), a novel analog of salvinorin A, can interact with both systems and demonstrate therapeutic effects. We used mouse models of hypermotility, diarrhea, and abdominal pain. We also assessed the influence of PR-38 on the central nervous system by measurement of motoric parameters and exploratory behaviors in mice. Subsequently, we investigated the pharmacokinetics of PR-38 in mouse blood samples after intraperitoneal and oral administration. PR-38 significantly inhibited mouse colonic motility in vitro and in vivo. Administration of PR-38 significantly prolonged the whole GI transit time, and this effect was mediated by µ- and κ-opioid receptors and the CB1 receptor. PR-38 reversed hypermotility and reduced pain in mouse models mimicking functional GI disorders. These data expand our understanding of the interactions between opioid and cannabinoid systems and their functions in the GI tract. We also provide a novel framework for the development of future potential treatments of functional GI disorders.

  14. Stochastic Calculus of Wrapped Compartments

    CERN Document Server

    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.

  15. Modified sliding myofascial flap of the rectus abdominus muscles for the closure of huge planned abdominal hernia%改良双侧腹直肌推徙术治疗巨大计划性腹疝

    Institute of Scientific and Technical Information of China (English)

    孙士锦; 张连阳

    2013-01-01

    Abdominal increment is applied to patients with abdominal compartment syndrome (ACS) after severe trauma,while for some patients,intra-abdominal volume increment could not close the fascia within the primary stage.For theses patients,abdominal wound skin grafting was conducted,and the planned hernia was formed.Planned abdominal hernia developed over time,and finally huge incisional hernia was formed.This article described a modified sliding myofascial flap of the rectus abdominus muscles for definitive abdominal wall reconstruction for a patient with huge planned abdominal hernia,and a good curative effect was obtained.%严重创伤后腹腔间隙综合征患者,需行腹腔扩容术.腹腔扩容术后部分患者不能行一期确定性关闭腹壁筋膜层,只能施行腹壁创面植皮术,从而形成计划性腹疝.随着时问延长,计划性腹疝的疝环进行性扩大,成为巨大腹壁切口疝.第三军医大学大坪医院野战外科研究所对1例巨大计划性腹疝患者施行改良双侧腹直肌推徙术,成功进行了确定性腹壁重建.实践证明该术式是一种安全、可靠的方法.

  16. Pre-eclampsia renamed and reframed: Intra-abdominal hypertension in pregnancy.

    Science.gov (United States)

    Sawchuck, Diane J; Wittmann, Bernd K

    2014-11-01

    This hypothesis proposes pre-eclampsia is caused by intra-abdominal hypertension in pregnancy. Sustained or increasing intra-abdominal pressure ⩾12mmHg causes impaired venous return to the heart, systemic vascular resistance, ischemia reperfusion injury, intestinal permeability, translocation of lipopolysaccharide endotoxin to the liver, cytotoxic immune response, systemic inflammatory response, pressure transmission to thoracic and intra-cranial compartments, and multi-organ dysfunction. This hypothesis is predicated on Pascal's law, evidence founded in the intra-abdominal hypertension literature, and the adapted equation ΔIAP-P=ΔIAVF/Cab, where ΔIAP-P=change in intra-abdominal pressure in pregnancy, ΔIAVF=change in intra-abdominal vector force (volume and force direction) and Cab=abdominal compliance. Factors causing increased intra-abdominal pressure in pregnancy include: progressive uterine expansion, obstetrical factors that increase intra-uterine volume excessively or acutely, maternal anthropometric measurements that affect intra-abdominal pressure thresholds, maternal postures that increase abdominal force direction, abdominal compliance that is decreased, diminished with advancing gestation, or has reached maximum expansion, habitation at high altitude, and rapid drops in barometric pressure. We postulate that the threshold for lipopolysaccharide translocation depends on the magnitude of intra-abdominal pressure, the intestinal microbiome complex, and the degree of intestinal permeability. We advance that delivery cures pre-eclampsia through the mechanism of abdominal decompression.

  17. Recurrent Abdominal Pain

    Science.gov (United States)

    Banez, Gerard A.; Gallagher, Heather M.

    2006-01-01

    The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

  18. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

    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.

  19. Gastrointestinal causes of abdominal pain.

    Science.gov (United States)

    Marsicano, Elizabeth; Vuong, Giao Michael; Prather, Charlene M

    2014-09-01

    Gastrointestinal causes of abdominal pain are numerous. These causes are reviewed in brief here, divided into 2 categories: acute abdominal pain and chronic abdominal pain. They are further subcategorized by location of pain as it pertains to the abdomen.

  20. Functional Abdominal Pain in Children

    Science.gov (United States)

    ... functional abdominal pain. Functional abdominal pain can be intermittent (recurrent abdominal pain or RAP) or continuous. Although ... tests are needed or whether a trial of diet changes, stress management or medication may be started. ...

  1. Anatomical variations within the deep posterior compartment of the leg and important clinical consequences.

    Science.gov (United States)

    Hislop, M; Tierney, P

    2004-09-01

    The management of musculoskeletal conditions makes up a large part of a sports medicine practitioner's practice. A thorough knowledge of anatomy is an essential component of the armament necessary to decipher the large number of potential conditions that may confront these practitioners. To cloud the issue further, anatomical variations may be present, such as supernumerary muscles, thickened fascial bands or variant courses of nerves and blood vessels, which can themselves manifest as acute or chronic conditions that lead to significant morbidity or limitation of activity. There are a number of contentious areas within the literature surrounding the anatomy of the leg, particularly involving the deep posterior compartment. Conditions such as chronic exertional compartment syndrome, tibial periostitis (shin splints), peripheral nerve entrapment and tarsal tunnel syndrome may all be affected by subtle anatomical variations. This paper primarily focuses on the deep posterior compartment of the leg and uses the gross dissection of cadaveric specimens to describe definitively the anatomy of the deep posterior compartment. Variant fascial attachments of flexor digitorum longus are documented and potential clinical sequelae such as chronic exertional compartment syndrome and tarsal tunnel syndrome are discussed.

  2. [Inflammatory abdominal aortic aneurysm].

    Science.gov (United States)

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  3. Hybrid Calculus of Wrapped Compartments

    CERN Document Server

    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...

  4. Abdominal wall endometriosis.

    Science.gov (United States)

    Upadhyaya, P; Karak, A K; Sinha, A K; Kumar, B; Karki, S; Agarwal, C S

    2010-01-01

    Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.

  5. Prevention and Investigation on Osteofascial Compartment Syndrome in Long Distance Running%长跑运动中骨筋膜室综合征的防治与研究

    Institute of Scientific and Technical Information of China (English)

    林恬; 朱洪彪; 姜伯乐

    2011-01-01

    Through using the method of tracking observation, questionnaire and interview, this paper makes study on reason, principle and prevention of OCS in long distance running of 3526 college students. The result shows that 4 in 5 students who have OCS adopt the brake, port cold compress, put extremities up and other suitable disposes. The function resumes being good after healing. Aftercutting the osteofascial compartment in hospital, one case is more serious, and no sequelae are observed.%采用跟踪观察、问卷调查和访谈等方法,对浙江省3526名大学生长跑运动员在长跑运动训练中,引起小腿筋膜室综合征的原因、原理及防治方法进行分析与研究。结果表明:患骨筋膜室综合征者5例,其中4例、采用制动,局部冷敷,抬高肢体及合理的处理,愈后功能均恢复良好,较为严重的1例,经医院手术切开行筋膜间隙后,愈合无后遗症。

  6. [Abdominal pregnancy: hormon concentrations during the postpartal period with placenta remaining intra-abdominal (author's transl)].

    Science.gov (United States)

    Gethmann, U; Mönkemeier, D

    1977-07-01

    It is reported of an abdominal pregnancy at term. The placenta was left in situ because of the high risk of intraabdominal bleedings. Thereby it was possible to measure hormon concentrations of the fetoplacental unit without the fetal compartment. Within 10 days after delivery we determined the plasma levels of estradiol-17 beta, estriol, progesterone, HCS, alpha1fetoprotein, and the excretion of the total estrogens in the urines. There was near the same decrease of hormon concentrations in the post partal time comparable with that of a normal pregnancy. Only the HCS concentrations didn't change in the first 9 days after delivery.

  7. 14 CFR 29.853 - Compartment interiors.

    Science.gov (United States)

    2010-01-01

    ... applicable: (1) Interior ceiling panels, interior wall panels, partitions, galley structure, large cabinet walls, structural flooring, and materials used in the construction of stowage compartments (other...

  8. Abdominal tuberculosis: Imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: jmpjesus@yahoo.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)

    2005-08-01

    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.

  9. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...

  10. [The abdominal catastrophe].

    Science.gov (United States)

    Seiler, Christian A

    2011-08-01

    Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

  11. Abdominal ultrasound (image)

    Science.gov (United States)

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  12. Abdominal x-ray

    Science.gov (United States)

    ... are, or may be, pregnant. Alternative Names Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also ...

  13. 灸法对肠易激综合征慢性内脏痛镇痛效应的研究与展望%Moxibustion therapy for chronic abdominal pain due to irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    包春辉; 吴焕淦; 黄任佳; 王硕硕; 周志刚; 胡智海; 赵继梦; 王思瑶; 谭琳蓥; 刘世敏

    2015-01-01

    BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on aleviating chronic visceral pain in irritable bowel syndrome patients. OBJECTIVE: To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion. METHODS: With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization. RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fuly understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controled trials employing advanced scientific techniques and equipments wil stil be needed in the future.%背景:慢性内脏痛是肠易激综合征患者最主要的临床表现之一,患者的生活质量受到严重影响。近年研究表明,灸法对肠易激综合征患者慢性内脏痛的治疗取得了一定

  14. Linear abdominal trauma.

    Science.gov (United States)

    Danto, L A; Wolfman, E F

    1976-03-01

    Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.

  15. Clinical research on chronic lumbosacral osteo-fascial compartment syndrome treated with limited-acupotomy therapy%针刀"有限"减压法治疗腰骶部慢性骨筋膜间隔综合征的临床研究

    Institute of Scientific and Technical Information of China (English)

    王荣国; 林新晓; 饶景飞; 章永东; 郭长青

    2011-01-01

    Objective To study the curative effect of limited-acupotomy therapy on chronic lumbosacral osteo-fascial compartment syndrome. Methods 59 patients were randomly recruited into a control group (with 29 patients) and a treatment group (with 30 patients). The control group was treated with general-acupotomy therapy, and treatment group was treated with limited-acupotomy therapy. Evaluate the curative effects before the first and the second therapy, and 3 months after the therapy respectively, as well as VAS pain, JOA and CODI scores. Results The curative effect was 96.56% and 100% respectively in the control group and the treatment group 3 months after the treatment. The difference between the two groups was not statistically significant(χ2=0.19,P> 0.05). As to VAS pain scores, JOA and CODI scores, the difference among the three stages of the treatment were significant (in control group F=165.70, 99.90, 106.60 respectively, in treatment group F=279.76, 154.34, 67.36 respectively, P<0.01)in both groups respectively, but the difference between the two groups were not significant(P>0.05) in each stage. Conclusion Limited-acupotomy therapy was safe and effective in treating chronic lumbosacral osteo-fascial compartment syndrome.%目的 观察针刀"有限"减压法治疗腰骶部慢性骨筋膜间隔综合征(chronic compartment syndrome,CCS)的临床疗效.方法 按病例尾号将59 例患者随机分为两组,对照组29例采用针刀常规松解法治疗,治疗组30 例采用针刀"有限"减压法治疗,在第1 次、第2 次治疗前和治疗3 个月后,分别进行疼痛视觉模拟标尺法(VAS)、功能障碍指数(CODI)等评分以评价疗效.结果 治疗结束后3 个月随访,对照组有效率为96.56%,治疗组有效率为100%,两组有效率比较,差异无统计学意义(χ2=0.19,P>0.05).两组各阶段治疗前后的疼痛VAS 、JOA、CODI 评分组内比较,差异均有统计学意义(对照组F 值分别为165.70 、99.90、106.60,

  16. Effect of different process model on the compartment syndrome prevention after serious fracture of tibial plateau%不同处理方式预防严重胫骨平台骨折后骨筋膜室综合征的效果比较

    Institute of Scientific and Technical Information of China (English)

    蒋群花; 杨莹; 张秀凤; 冯洁; 沈丽

    2012-01-01

    目的 比较3种不同处理方式对预防严重胫骨平台骨折后骨筋膜室综合征的效果.方法 将90例严重胫骨平台骨折患者随机分为3组,小腿按压组患者30例给予小腿静脉按压,冰袋冷敷组患者30例给予冰袋冷敷,对照组30例进行常规护理,3组患者入院后均给予常规脱水剂快速静脉滴注.比较3组效果.结果 在骨筋膜室综合征的发生率、张力性水疱、1周内皮肤皱褶方面冰袋冷敷组与对照组比较差异有统计学意义(1比4,3比9,22比15;x2值分别为4.284,3.822,3.875;P<0.05),小腿按压组与对照组比较差异也有统计学意义(0比4,2比9,23比15;x2值分别为4.784,5.986,4.593;P <0.05);而冰袋冷敷组与小腿按压组之间差异无统计学意义(x2值分别为0.005,0.215,0.085;P>0.05).结论 早期局部冰袋冷敷和小腿静脉按压均能减轻软组织的肿胀,预防骨筋膜室综合征发生.%Objective To compare the effect of three different process models on the compartment syndrome prevention after serious fracture of tibial plateau.Methods Totals of 90 cases with serious fracture of tibial plateau were randomly divided into three groups,with 30 cases every group,crus press group received the intervention of leg vein press,cold packs group received the cold packs intervention,and the control group received the traditional nursing care.All the patents received the rapid intravenous drip of dehydrant.Results The incidence of compartment syndrome,tension sex blisters,skin folds in one week of cold packs group was significantly different with that of control group( 1 vs 4,3 vs 9,22 vs 15;x2 =4.284,3.822,3.875,respectively;P < 0.05 ),and between crus press group and control group,the difference was statistically significant (0 vs 4,2 vs 9,23 vs 15; x2 =4.784,5.986,4.593,respectively; P < 0.05 ),while there was no significantly difference between cold packs group and crus press group( P > 0.05 ).Conclusions The process model of

  17. Compartmented mode workstation (CMW) comparisons

    Energy Technology Data Exchange (ETDEWEB)

    Tolliver, J.S.

    1995-12-31

    As the Compartmented Mode Workstation (CMW) market has matured, several vendors have released new versions of their CMW operating systems. These include a new version from SecureWare (CMW + Version 2.4), and Sun`s CMW 1.1 (also known as Trusted Solaris 1.1). EC is now shipping MLS+ 3.0 for DEC Alpha platforms. Relatively new entries in the market include Loral B1/CMW for IBM RS/6000 platforms and a SecureWare-based CMW for HP platforms (HP-UX 10.09). With all these choices it is time for a comparative analysis of the features offered by the various vendors. The authors have three of the above five CMW systems plus HP-UX BLS 9.09, which is a multilevel secure operating system (OS) targeted at the B1 level but not a CMW. Each is unique in sometimes obvious, sometimes subtle ways, a situation that requires knowing and keeping straight a variety of commands to do the same thing on each system. Some vendors offer extensive GUI tools for system administration; some require entering command-line commands for certain system administration tasks. They examine the differences in system installation, system administration, and system operating among the systems. They look at trusted networking among the various systems and differences in the network databases and label encodings files. They examine the user interface on the various systems from logging in to logging out.

  18. Clinical application comparison of abdominal ultrasound and vagina ultrasound in diagnosis of polycystic ovary syndrome%经腹部超声和经阴道超声诊断多囊卵巢综合征

    Institute of Scientific and Technical Information of China (English)

    李琴

    2015-01-01

    Objective To compare the application velue of transabdominal ultrasound and transvaginal ultrasound in diagnosis of polycystic ovary syndrome(PCOS).Methods Sixty cases of polycystic ovary syndrome were chose as group PCOS,55 cases of hospitalized healthy subjects were chose as control group.After admission,they were treated with abdominal ultrasound and trmsvaginal ultrasonography.The ovarian medulla area (S),ovarian section area (A),the number of follicles (NF) andovarian volume (OV) and the value of S:A was calculated.Results Transvaginal ultrasound detection value of NF was 14.89 ±3.68,which was significantly higher than that of abdominal ultrasonography,there was significant difference (P < 0.05).In PCOS group,NF,OV,A,S,S/A respectively was (13.26 ± 4.15) and (0.28 ± 3.62) V/cm3,(5.33 ± 1.7) V/cm3,(2.30 ±0.74) V/cm3,(3.41 ±0.07),which was significantly higher than those in the control group,there were significant differences(P <0.05).Ultrasound examination showed that left and right ovaries had homogeneous increasing trend,clearboundary,medulla area showed a trend of obviously increase.Abdominal ultrasound showed no echo,transvaginal ultrasonography revealed the presence of a wheel like echo.Conclusions A,S,S/A detection value can be used in diagnosis of polycystic ovary syndrome,ultrasonography image of ovarian transvaginal ultrasound is clear,when necessary,the two ways can be combined to improve the diagnostic rate.%目的 对比分析经腹部超声和经阴道超声诊断在多囊卵巢综合征中的应用价值.方法 以60例多囊卵巢综合征(PCOS)患者作为PCOS组,取55例同期入院体检正常者作为对照组,入院后均行经腹部超声和经阴道超声检查,计算卵巢髓质面积(S)、卵巢切面面积(A)、卵泡数量(NF)以及卵巢体积(-V)以及S:A的值.结果 经阴道超声检测的NF值为14.89±3.68,显著高于经腹部超声检查,差异有统计学意义(P<0.05).PCOS组NF、OV、A、S、S/A值分别为(13

  19. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    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.

  20. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Childhood abdominal cystic lymphangioma

    Energy Technology Data Exchange (ETDEWEB)

    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

  3. Abdominal paracentesis and thoracocentesis.

    Science.gov (United States)

    Lee, Ser Yee; Pormento, James G; Koong, Heng Nung

    2009-04-01

    Abdominal paracentesis and thoracocentesis are common bedside procedures with diagnostic, therapeutic and palliative roles. We describe a useful and familiar a useful and familiar technique with the use of a multiple lumen catheter commonly used for central venous line insertion for drainage of ascites or moderate to large pleural effusions. The use of a multiple lumen catheter allows easier and more rapid aspiration of fluid with a smaller probability of the side holes being blocked as compared to the standard needle or single catheter methods. This is particularly useful in situations where the dedicated commercial kits for thoracocentesis and abdominal paracentesis are not readily available.

  4. [Abdominal actinomycosis with IUD].

    Science.gov (United States)

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  5. A Spatial Calculus of Wrapped Compartments

    CERN Document Server

    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.

  6. Adult abdominal hernias.

    LENUS (Irish Health Repository)

    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.

  7. Screening for Abdominal Aortic Aneurysm

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final ...

  8. Abdominal aortic aneurysm repair - open

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007392.htm Abdominal aortic aneurysm repair - open To use the sharing features on this page, please enable JavaScript. Open abdominal aortic aneurysm repair is surgery to fix a widened part ...

  9. An abdominal aortic rupture due to seatbelt blunt injury: report of a case.

    Science.gov (United States)

    Sugimoto, Takaki; Omura, Atsushi; Kitade, Takashi; Takahashi, Hideyuki; Koyama, Takashi; Kurisu, Sigeru

    2007-01-01

    A 66-year-old man, who was a passenger in a car involved in a low-speed head-on motor vehicle accident, was rushed to our hospital. His abdomen was tender and distended. An enhanced computed tomography scan showed a massive retroperitoneal hematoma, and its three-dimensional imaging revealed an active leak of the contrast medium from the aortic bifurcation. He went into shock, and was immediately transferred to the operating theater. Through a median laparotomy, a ruptured site measuring 5 mm in diameter was found at the aortic bifurcation and it was closed with sutures under a proximal aortic control. The other organs showed no evidence of injury. Because of the remarkable edema of the bowel, mesentery, and retroperitoneum, the abdomen was temporarily closed with a mesh sheet to prevent the occurrence of abdominal compartment syndrome. A delayed closure was then successfully performed 4 days later, and he was discharged with no residual sequelae 17 days after the initial operation.

  10. 5-羟色胺转运体在肠易激综合征腹痛机制中的研究%Research of serotonin transporter in the mechanism of abdominal pain in irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    王静; 徐萍; 诸琦

    2010-01-01

    Objective To investigate the role of serotonin transporter (SERT) in pathogenesis of abdominal pain in irritable bowel syndrome (IBS). Methods Neonatal SD rats were divided into control group and IBS abdominal pain model group which was established by colorectal distension.The colon, nucleus raphes dorsalis (NRD) and prefrontal cortex (FC) tissues were harvested when all rats grew into adults. Expressions of SERT and 5-HT were determined by real-time PCR and immunohistochemistry. Results The expression of SERT mRNA in colon, NRD and FC tissues in model and control group were 13.95±2.05 vs 8.65±1.33, 52.69±22.59 vs 13.82±5.71 and0.48±0.17 vs 0.17±0.14, respectively, with significant differences (all P values <0.05). The protein expression of SERT in colon and NRD,but not FC tissues,decreased in model group compared with control group (13.19±3.82 vs 21.35±4.49,2.47±0.44 vs 4.55±0.92, respectively, P<0.05).Meanwhile, in comparison with control group, the expression of 5-HT in colon was significantly increased in model group (5.56±0.48 vs 2.68±0.22), but decreased in NRD and FC tissues (3.75±0.43 vs 7.46±0.72, 5.07 ± 0.80 vs 7.97 ±1.10, respectively, P<0.05). Conclusions Low expression of SERT in brain and colon may attribute to the pathogenesis of abdominal pain in IBS.%目的 探究5-羟色胺转运体(SERT)在肠易激综合征腹痛机制中的作用.方法 构建新生大鼠肠易激综合征腹痛模型,在其成年后取其结肠、脑干、额前皮质组织,应用免疫组化及实时PCR法检测各组织SERT定位和表达,并对各组织中5-羟色胺进行半定量分析.结果 模型组与对照组大鼠结肠、脑干、额前皮质中SERT mRNA表达水平分别为13.95±2.05比8.65±1.33、52.69±22.59比13.82±5.71、0.48±0.17比0.17±0.14,结肠、脑干中SERT蛋白表达水平分别为13.19±3.82比21.35±4.49、2.47±0.44比4.55±0.92,差异均有统计学意义(P值均<0.05),额前皮质SERT蛋白表达

  11. Endovascular treatment of a small infrarenal abdominal aortic aneurysm causing duodenal obstruction: Case report and literature review.

    Science.gov (United States)

    Esposito, Andrea; Menna, Danilo; Mansour, Wassim; Sirignano, Pasqualino; Capoccia, Laura; Speziale, Francesco

    2015-06-01

    Duodenal obstruction caused by abdominal aortic aneurysm was first described by Osler in 1905 and is named "aortoduodenal syndrome." This condition has always been treated by open surgical repair. We report the first case of aortoduodenal syndrome successfully treated by endovascular aneurysm repair. A 74-year-old male patient referred to our hospital complaining postprandial vomit, reporting a consistent weight loss in the latest weeks. Enhanced computed tomography scans showed a small saccular abdominal aortic aneurysm compressing duodenum and inferior vena cava without any other evident pathological finding. As the patient underwent a successful endovascular treatment of the abdominal aortic aneurysm, symptoms immediately resolved so that he started back to feed and progressively gained body weight. Despite aortoduodenal syndrome is generally caused by large abdominal aortic aneurysm, this condition has to be suspected also in case of small abdominal aortic aneurysm. Differently from what has been reported in literature, endovascular aneurysm repair could be effective in the treatment of aortoduodenal syndrome.

  12. Physicians' Abdominal Auscultation

    DEFF Research Database (Denmark)

    John, Gade; Peter, Kruse; Andersen, Ole Trier

    1998-01-01

    Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... of the intestinal sounds from 8 patients with acute abdominal pain and 4 healthy volunteers were presented to 100 physicians. The physicians were asked to characterize the intestinal sounds as normal or pathologic. Fisher's exact test was used for comparison between groups of physicians. Results: Overall, 72......% of the answers with regard to healthy volunteers concluded that the sounds were normal (equalling agreement), whereas 64% of answers with regard to intestinal obstruction concluded that the sounds were pathologic (but agreement was higher due to agreement on wrong diagnosis in one case). Bowel sounds from...

  13. Ruptured abdominal aortic aneurysm.

    Science.gov (United States)

    Sachs, T; Schermerhorn, M

    2010-06-01

    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  14. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. Application of vacuum-sealing drainage based on biomaterial wound surface dressing in incision decompression of osteofascial compartment syndrome%基于生物材料创面敷料封闭负压引流在骨筋膜室综合征切开减压中的应用

    Institute of Scientific and Technical Information of China (English)

    徐海栋; 陈勇; 赏后来; 卢俊浩; 赵建宁

    2012-01-01

    BACKGROUND: Muscle bulging in vitro, stale bone wounds caused by a large number of tissue fluid exudation and highincidence of infection often appear after incision decompression of osteofascial compartment syndrome, and these are notconducive to patient recovery. Vacuum-sealing drainage (VSD) can protect the wound and avoid local toxins to enter into theblood.OBJECTIVE: To study the curative effect of VSD based on biomaterial wound surface dressing on incision decompression ofosteofascial compartment syndrome.METHODS: Osteofascial compartment syndrome patients received incision decompression were divided into three groups bytheir wishes: VSD based on biomaterial wound dressing group, VSD based on synthetic wound dressing group and routinepressure dressing group. Indexes of liver and kidney functions and freshness of granulation particles were observed in all patientsafter 3 days of treatment.RESULTS AND CONCLUSION: The technique of VSD could significantly protect liver and kidney functions, and the freshness ofgranulation particles in the VSD groups were better compared with the routine pressure dressing group (P < 0.05). Blistersaround the wound could be seen in partial patients of the VSD based on synthetic wound dressing group during drainage. It isindicated that VSD based on the new biomaterial wound dressing can effectively drainage, protect liver and kidney functions byavoid toxins entering into the blood, and have a satisfactory freshness of granulation particles. It can provide a good woundsurface for later skin grafting and have a good biocompatibility.Xu HD, Chen Y, Shang HL, Lu JH, Zhao JN. Application of vacuum%背景 骨筋膜室综合征切开减压后往往出现肌肉膨出体外、大量组织液渗出导致肌肉创面不新鲜、易发生感染等不利于患者恢复,应用封闭负压引流可以保护创面,避免局部毒素入血.目的 观察基于自主研发的生物材料创面敷料封闭负压引流在骨筋膜室综合征

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

    Science.gov (United States)

    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.

  17. Endovascular Exclusion of an Abdominal Aortic Aneurysm in Patients with Concomitant Abdominal Malignancy: Early Experience

    Energy Technology Data Exchange (ETDEWEB)

    Choi, You Ri; Chang, Nam Kyu [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Shin, Hyo Hyun; Oh, Hyun Jun; Kim, Jae Kyu; Choi, Soo Jin Na; Chung, Sang Young [Chonnam National University Hospital, Gwangju (Korea, Republic of); Yim, Nam Yeol [Armed Forces Yangju Hospital, Yangju (Korea, Republic of)

    2010-08-15

    To assess the outcomes of endovascular aortic aneurysm repair (EVAR) for the treatment of an abdominal aortic aneurysm in patients undergoing curative surgical treatment for concomitant abdominal malignancy. The study included 12 patients with abdominal neoplasia and an abdominal aortic aneurysm (AAA), which was treated by surgery and stent EVAR. The neoplasm consisted of the gastric, colorectal, pancreas, prostate, and gall bladder. The follow up period was 3-21 months (mean 11.8 months). All medical records and imaging analyses were reviewed by CTA and/or color Doppler US, retrospectively. Successful endoluminal repair was accomplished in all twelve patients. The mean interval time between EVAR and surgery was 58.6 days. Small amounts of type 2 endoleaks were detected in two patients (17%). One patient developed adult respiratory distress syndrome after Whipple's operation 20 days after surgery, which led to hopeless discharge. No procedure-related mortality, morbidity, or graft-related infection was noted. Exclusion of AAA in patients with accompanying malignancy show with a relatively low procedure morbidity and mortality. Hence, endoluminal AAA repair in patients with synchronous neoplasia may allow greater flexibility in the management of an offending malignancy

  18. Risk factors of thrombosis in abdominal veins

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Effects of combustible stacking in large compartments

    DEFF Research Database (Denmark)

    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...... of non uniform distribution of the combustible materials and fire propagation. These aspects are discussed in this paper with reference to an industrial steel building, taken as case study. Fires triggered by the burning of wooden pallets stored in the premises have been investigated with respect...

  20. Uterine adenocarcinoma with abdominal carcinomatosis in a beluga whale.

    Science.gov (United States)

    Lair, S; De Guise, S; Martineau, D

    1998-04-01

    A case of uterine adenocarcinoma is reported in a 26-yr-old, free-ranging beluga whale (Delphinapterus leucas) from the St. Lawrence estuary (Quebec, Canada). This neoplasm appeared as a segmental stenotic thickening of the left uterine horn composed of well differentiated, but disorganized and infiltrative, glandular structures surrounded by an extensive scirrhous stroma. Abdominal carcinomatosis was observed on the mesosalpinx and on the serosal aspect of the gastric compartments. This is the first report of a malignancy originating in the uterus of a cetacean.

  1. Abdominal obesity, cardiometabolic risk and endocannabinoid system

    Directory of Open Access Journals (Sweden)

    G. Bittolo Bon

    2013-05-01

    Full Text Available Abdominal obesity is the most prevalent manifestation of metabolic syndrome and is of central importance in the definition of global cardiometabolic risk. Visceral adipose tissue releases a large number of bioactive mediators, which influence body weight homeostasis, insulin resistance, alterations in lipids, blood pressure, coagulation, fibrinolysis and inflammation, leading to increased risk of cardiovascular events and of type 2 diabetes. Lifestyle modification is the first-line approach to the management of abdominal obesity and metabolic syndrome. However for patients at higher risk, who cannot achieve an appreciable reduction in weight and in global cardiometabolic risk with lifestyle modification alone, an adjunctive long term pharmacotherapy should be considered. The endocannabinoid system activity regulates food intake and metabolic factors through cannabinoid-1 (CB1 receptor located in multiple sites, including hypothalamus and limbic forebrain, adipose tissue, skeletal muscle, liver and the gastrointestinal tract. Evidence suggests that CB1 receptor blockade offers a novel therapeutic strategy. Data from four phase III trials suggest that rimonabant, the first cannabinoid receptor inhibitor, modulates cardiometabolic risk factors, both through its impact on body weight and metabolic parameters such as HDL-cholesterol, tryglicerides, Hb1Ac, through direct pathways that are not related to weight loss.

  2. The medial tibial stress syndrome. A cause of shin splints.

    Science.gov (United States)

    Mubarak, S J; Gould, R N; Lee, Y F; Schmidt, D A; Hargens, A R

    1982-01-01

    The medial tibial stress syndrome is a symptom complex seen in athletes who complain of exercise-induced pain along the distal posterior-medial aspect of the tibia. Intramuscular pressures within the posterior compartments of the leg were measured in 12 patients with this disorder. These pressures were not elevated and therefore this syndrome is a not a compartment syndrome. Available information suggests that the medial tibial stress syndrome most likely represents a periostitis at this location of the leg.

  3. Pelvic compartment syndrome caused by retroperitoneal hematoma of pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Feng-qi; ZHANG Ying-ze; PAN Jin-she; PENG A-qin; WANG Hui-juan

    2005-01-01

    @@ Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis.

  4. Diagnosis of Compartment Syndrome Based on Tissue Oxygenation

    Science.gov (United States)

    2015-06-01

    was added in our model. Dobutamine is an inotropic agent commonly used in patients with cardiogenic shock to increase heart rate, contractility, and...to soft tissue edema and skin turgor changes after trauma that alter the depth of the muscle to be evaluated and the ability of the probe to maintain...and cardiogenic shock. Infection. 1991;19:317–323. 18. Bylund-Fellenius AC, Walker PM, Elander A, et al. Energy metabolism in relation to oxygen partial

  5. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-02

    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.

  6. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    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 553......, 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....

  7. Lower Abdominal Pain.

    Science.gov (United States)

    Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S

    2016-05-01

    Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation.

  8. Dolor abdominal recurrente .

    Directory of Open Access Journals (Sweden)

    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.

  9. Abdominal perfusion computed tomography.

    Science.gov (United States)

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-02-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  10. Abdominal pregnancy- a case report.

    Science.gov (United States)

    Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc

    2011-01-01

    A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.

  11. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  13. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    a multiple imputation analysis, this difference disappeared (relative risk, 1.36; 95% confidence interval, 0.86-2.13; P = .19). No differences were seen in any of the secondary outcomes. CONCLUSION: Subtotal abdominal hysterectomy was not superior to total abdominal hysterectomy on any outcomes. More women...

  14. Abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal

    2010-01-01

    Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective....... The acceptance rate was 77%, and 95% accept control scans. Furthermore, persons at the highest risk of having an AAA attend screening more frequently. We found that 97% of the interval cases developed from aortas that initially measured 2.5-2.9 cm - i.e. approx. only 5% attenders need re-screening at 5-year...... methods for measuring the degree of wall calcification must be developed and validated....

  15. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    Science.gov (United States)

    Cervellin, Gianfranco; Lippi, Giuseppe

    2015-06-01

    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established.

  16. Ergonomic Evaluation on Taxi Drivers Compartment

    Institute of Scientific and Technical Information of China (English)

    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...

  17. Actin: its cumbersome pilgrimage through cellular compartments.

    Science.gov (United States)

    Schleicher, Michael; Jockusch, Brigitte M

    2008-06-01

    In this article, we follow the history of one of the most abundant, most intensely studied proteins of the eukaryotic cells: actin. We report on hallmarks of its discovery, its structural and functional characterization and localization over time, and point to present days' knowledge on its position as a member of a large family. We focus on the rather puzzling number of diverse functions as proposed for actin as a dual compartment protein. Finally, we venture on some speculations as to its origin.

  18. VACUUM THERAPY VERSUS ABDOMINAL EXERCISES ON ABDOMINAL OBESITY

    Directory of Open Access Journals (Sweden)

    Nevein Mohammed Mohammed Gharib

    2016-06-01

    Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.

  19. Compartment-Specific Phosphorylation of Squid Neurofilaments.

    Science.gov (United States)

    Grant, Philip; Pant, Harish C

    2016-01-01

    Studies of the giant axon and synapse of third-order neurons in the squid stellate ganglion have provided a vast literature on neuronal physiology and axon transport. Large neuronal size also lends itself to comparative biochemical studies of cell body versus axon. These have focused on the regulation of synthesis, assembly, posttranslational modification and function of neuronal cytoskeletal proteins (microtubules (MTs) and neurofilaments (NFs)), the predominant proteins in axoplasm. These contribute to axonal organization, stability, transport, and impulse transmission responsible for rapid contractions of mantle muscles underlying jet propulsion. Studies of vertebrate NFs have established an extensive literature on NF structure, organization, and function; studies of squid NFs, however, have made it possible to compare compartment-specific regulation of NF synthesis, assembly, and function in soma versus axoplasm. Since NFs contain over 100 eligible sites for phosphorylation by protein kinases, the compartment-specific patterns of phosphorylation have been a primary focus of biochemical studies. We have learned that NF phosphorylation is tightly compartmentalized; extensive phosphorylation occurs only in the axonal compartment in squid and in vertebrate neurons. This extensive phosphorylation plays a key role in organizing NFs, in association with microtubules (MTs), into a stable, dynamic functional lattice that supports axon growth, diameter, impulse transmission, and synaptic activity. To understand how cytoskeletal phosphorylation is topographically regulated, the kinases and phosphatases, bound to NFs isolated from cell bodies and axoplasm, have also been studied.

  20. Bacterial translocation - impact on the adipocyte compartment.

    Science.gov (United States)

    Kruis, Tassilo; Batra, Arvind; Siegmund, Britta

    2014-01-01

    Over the last decade it became broadly recognized that adipokines and thus the fat tissue compartment exert a regulatory function on the immune system. Our own group described the pro-inflammatory function of the adipokine leptin within intestinal inflammation in a variety of animal models. Following-up on this initial work, the aim was to reveal stimuli and mechanisms involved in the activation of the fat tissue compartment and the subsequent release of adipokines and other mediators paralleled by the infiltration of immune cells. This review will summarize the current literature on the possible role of the mesenteric fat tissue in intestinal inflammation with a focus on Crohn's disease (CD). CD is of particular interest in this context since the transmural intestinal inflammation has been associated with a characteristic hypertrophy of the mesenteric fat, a phenomenon called "creeping fat." The review will address three consecutive questions: (i) What is inducing adipocyte activation, (ii) which factors are released after activation and what are the consequences for the local fat tissue compartment and infiltrating cells; (iii) do the answers generated before allow for an explanation of the role of the mesenteric fat tissue within intestinal inflammation? With this review we will provide a working model indicating a close interaction in between bacterial translocation, activation of the adipocytes, and subsequent direction of the infiltrating immune cells. In summary, the models system mesenteric fat indicates a unique way how adipocytes can directly interact with the immune system.

  1. Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Sevil Ikinci

    2010-10-01

    Full Text Available Metabolic Syndrome is a combination of risk factors including common etiopathogenesis. These risk factors play different roles in occurence of atherosclerotic diseases, type 2 diabetes, and cancers. Although a compromise can not be achieved on differential diagnosis for MS, the existence of any three criterias enable to diagnose MS. These are abdominal obesity, dislipidemia (hypertrigliceridemia, hypercholesterolemia, and reduced high density lipoprotein hypertension, and elevated fasting blood glucose. According to the results of Metabolic Syndrome Research (METSAR, the overall prevalence of MS in Turkey is 34%; in females 40%, and in males it is 28%. As a result of “Western” diet, and increased frequency of obesity, MS is observed in children and in adolescents both in the world and in Turkey. Resulting in chronic diseases, it is thought that the syndrome can be prevented by healthy lifestyle behaviours. [TAF Prev Med Bull 2010; 9(5.000: 535-540

  2. 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

    Directory of Open Access Journals (Sweden)

    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

  3. Random walks of cytoskeletal motors in open and closed compartments

    NARCIS (Netherlands)

    Lipowsky, R.; Klumpp, S.

    2001-01-01

    Random walks of molecular motors, which bind to and unbind from cytoskeletal filaments, are studied theoretically. The bound and unbound motors undergo directed and nondirected motion, respectively. Motors in open compartments exhibit anomalous drift velocities. Motors in closed compartments generat

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

    Data.gov (United States)

    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...

  5. Computed tomography of diseases involving the iliopsoas compartment; Tomografia computadorizada das patologias acometendo o compartimento iliopsoas

    Energy Technology Data Exchange (ETDEWEB)

    Montandon, Cristiano; Maeda, Lucimara; Bianchessi, Susana Trigo; Turi, Fabiano; Torriani, Martin [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Radiologia]. E-mail: torr@unicamp.br

    2001-02-01

    Our aim is to review the most common pathologic processes involving the iliopsoas compartment. We retrospectively reviewed the computed tomography (CT) scans performed at the Radiology Dept. of the Medical Sciences Faculty from Universidade Estadual de Campinas, in the last 10 years, of patients who presented with abnormalities of the iliopsoas compartment that were confirmed by surgical or percutaneous biopsy. The most common findings involving the iliopsoas compartment included neoplasms, abscesses and hematomas. CT findings were based on the extension of the involvement of the psoas muscle, focal areas of low or high attenuation, lesion margins, presence of gas or calcification within the lesion, bone destruction, infiltration of of surrounding fat and involvement of adjacent abdominal structures. CT is the method of choice for the detection of iliopsoas disorders, and its findings can be used to guide diagnostic aspiration, biopsy or drainage, when appropriate. However, the efficacy of CT in differentiating iliopsoas disorders is low when scans are interpreted without knowledge of clinical history. (author)

  6. [Changes of the intraabdominal pressure in patients with abdominal sepsis].

    Science.gov (United States)

    Kursov, S V

    2013-01-01

    64 patients with abdominal sepsis were included in the study of the intraabdominal pressure changes before and after the operation. The study demonstrated that the use of the crystalloids alone leads to the development of the capillary leak syndrome in comparison with the therapy regimen using colloids. The aggressive fluid resuscitation, associated with high numbers of central venous pressure, increasing 1177Pa (120 mm H2O), was connected with the increase of the intraabdominal pressure.

  7. Economics of abdominal wall reconstruction.

    Science.gov (United States)

    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.

  8. Radiation nephritis causing nephrotic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. Micromanaging Abdominal Aortic Aneurysms

    Directory of Open Access Journals (Sweden)

    Lars Maegdefessel

    2013-07-01

    Full Text Available The contribution of abdominal aortic aneurysm (AAA disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to “fine tune” the translational output of their target messenger RNAs (mRNAs by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility.

  10. Abdominal aortic feminism.

    Science.gov (United States)

    Mortimer, Alice Emily

    2014-01-01

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  11. Abdominal manifestations of cystic fibrosis in children

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  12. Fatigue and cardiorespiratory function following abdominal surgery.

    Science.gov (United States)

    Christensen, T; Bendix, T; Kehlet, H

    1982-07-01

    Subjective feelings of fatigue were assessed before operation and 10, 20 and 30 days after uncomplicated elective abdominal surgery in 16 otherwise healthy patients, using a constructed fatigue scale model. In addition, all patients had an orthostatic stress test performed at the same times. Six of the patients also underwent a bicycle ergometer test measuring heart rate and oxygen consumption. Subjective feelings of fatigue were increased (P less than 0.01) at all three postoperative observations, and only 5 of 16 patients returned to their preoperative level. The increased subjective feeling of fatigue correlated positively (RS = 0.53, P less than 0.001) with the increased pulse rate seen during orthostatic stress after operation. Heart rate was about 5 per cent higher (n.s.) after operation when bicycling at the same work loads, while oxygen consumption decreased by about 2 per cent (P less than 0.01) at all three postoperative bicycle tests. It is concluded that even electric uncomplicated abdominal surgery is followed by a pronounced feeling of fatigue, which may persist 1 month after surgery in about one-third of patients. The fatigue scale model seems applicable for future studies on the pathogenesis and treatment of the postoperative fatigue syndrome.

  13. Abdominal CT findings of delayed postoperative complications

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R.; Osadchy, A. [Sapir Medical Center, Dept. of Diagnostic Imaging, Kfar Saba (Israel)]. E-mail: zisinrivka@clalit.org.il; Gayer, G. [Assaf Harofe Medical Center, Dept. of Diagnostic Imaging, Zrifin (Israel)

    2007-10-15

    Despite progress in surgical techniques and modern medical treatment, postoperative complications occur not infrequently and vary according to type of surgery, clinical setting, and time elapsed since surgery. In general, they can be divided into early and delayed complications. Delayed postoperative complications can be classified as specific and nonspecific. The common nonspecific delayed complications are incisional hernia and postoperative bowel obstruction. Bowel obstruction can be further categorized as obstruction related to benign or neoplastic etiology, the latter occurring in oncology patients in whom the primary surgery was related to an underlying abdominal neoplasm. Gossypiboma is another, fortunately rare, postoperative complication. Specific complications appear after specific operations and include the following: Splenosis - following splenectomy. Retained gallstones and spilled gallstones - following cholecystectomy, mainly laparoscopic. Dropped appendicolith and stump appendicitis - following appendectomy, mainly laparoscopic. Obturation obstruction by a bezoar - following gastric surgery. Afferent loop syndrome (ALS) - following Bilroth II gastrectomy. (author)

  14. Abdominal US Findings of Disseminated Penicilliosis Marneffei in Patients with Acquired Immunodeficiency Syndrome%艾滋病合并播散性马尔尼菲青霉菌病腹部超声表现分析

    Institute of Scientific and Technical Information of China (English)

    吴碧君; 汤庆; 周爱群; 梁惠颖

    2011-01-01

    目的 探讨艾滋病(AIDS)合并播散性马尔尼菲青霉菌病(PSM)的腹部超声表现.方法 回顾性分析141例AIDS合并播散性PSM的腹部超声图像特征.结果 141例AIDS合并播散性PSM腹部超声表现为腹部淋巴结肿大98例(69.50%);肝脾肿大96例(68.08%);肝脾内局灶性、弥漫性病变共15例(10.63%),其中肝脾内弥漫性病变3例,图像非常有特征性,呈"云雾状";胰腺炎4例(2.83%);腹水12例(8.51%).结论 AIDS合并播散性PSM时,腹部常多脏器受累,腹膜后及肠系膜淋巴结肿大、肝脾肿大、肝脾实质病变是最常见的腹部超声表现.%Objective To investigate abdominal US findings of Disseminated Penicilliosis Mameffei in patients with AIDS.Methods Abdominal US imaging of Disseminated Penicilliosis Marneffei in 141 patients with AIDS were retrospectively analyzed.Results Enlargement of abdominal lymph nodes were observed in 98 (69.50 % )cases.Hepatosplenomegaly was observed in 96 (68.08 % )cases.Focal or diffuse lesions in the liver and spleen were observed in 15 ( 10.63 % )cases.3 case of diffuse lesions in the liver and spleen whose image was very specific "cloudy".Pancreatitis was observed in 4 cases(2.83%).Ascites was observed in 12 case(8.51%).Conclusions Disseminated Penicilliosis Mameffei in patients with AIDS usually were involved multiple organs in abdomem.Enlargement of abdominal lymph nodes, hepatosplenomegaly,parenehymal lesions in the liver and spleen are the most common US findings in abdomem.

  15. Intra-abdominal tuberculous peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B. [Dept. of Diagnostic Radiology, University Hospital, Homburg (Germany); Hennes, P. [Dept. of Pediatrics, University Hospital, Homburg (Germany); Pueschel, W. [Dept. of Pathology, University Hospital, Homburg (Germany); Karadiakos, N. [Dept. of Pediatric Surgery, University Hospital, Homburg (Germany)

    2001-07-01

    We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type of ... examinations do not use ionizing radiation (as used in x-rays ), thus there is no radiation exposure ...

  17. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... children. Except for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging ... of page How is the procedure performed? For most ultrasound exams, you will be positioned lying face- ...

  18. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed to evaluate ... for ultrasound examinations. top of page What does the equipment look like? Ultrasound scanners consist of a ...

  19. Microspectroscopy of the photosynthetic compartment of algae.

    Science.gov (United States)

    Evangelista, Valtere; Frassanito, Anna Maria; Passarelli, Vincenzo; Barsanti, Laura; Gualtieri, Paolo

    2006-01-01

    We performed microspectroscopic evaluation of the pigment composition of the photosynthetic compartments of algae belonging to different taxonomic divisions and higher plants. The feasibility of microspectroscopy for discriminating among species and/or phylogenetic groups was tested on laboratory cultures. Gaussian bands decompositions and a fitting algorithm, together with fourth-derivative transformation of absorbance spectra, provided a reliable discrimination among chlorophylls a, b and c, phycobiliproteins and carotenoids. Comparative analysis of absorption spectra highlighted the evolutionary grouping of the algae into three main lineages in accordance with the most recent endosymbiotic theories.

  20. Common abdominal emergencies in children.

    Science.gov (United States)

    D'Agostino, James

    2002-02-01

    Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.

  1. 简式中文版Oswestry功能障碍指数评定下背痛患者的信度及效度分析%Validity and reliability of simplified Chinese version of Oswestry disability index with chronic low back pain induced by lumbar chronic paraspinal compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    俞红; 白跃宏

    2010-01-01

    Objective To analyze validity and reliability of the simplified Chinese version of Oswestry disability index (SCODI) in evaluation of the effect of operation in Chinese patients with chronic low back pain (LBP) induced by lumbar chronic paraspinal compartment syndrome (LCCS).Methods One hundred and forty patients with chronic LBP induced by LCCS were enrolled in the study,and were treated with micro-invasive opening decompression operation on the lumbar compartment.Before and after operation,SCODI,Roland-Morris disability questionnaire(RDQ) and visual analogue scale (VAS) were used to evaluate the effect of operation,and the validity and reliability of SCODI were tested.Reliability analysis included:Spearman-Brown split-half reliability analyse;internal consistency Cronbach's coefficient,and test-retest of reliability interclaas correlation coefficient (ICC) analysis.Validity analysis included concurrent efficacy validity and construct validity.The coefficient between SCODI with RDQ,VAS and international classification of functioning,disability and health (ICF) core set item were analyzed. Results Reliability analysis:SCODI scale Spearman-Brown split half reliability coefficient was 0.746,good internal consistency was found (Cronbach's α=0.884),the ICC of test-retest was 0.907.Validity analysis:The SCODI scale KMO measure was 0.82 ,the Spearman coefficient with RDQ,VAS and ICF core set was 0.783,0.945 and 0.865 (P <0.01) before the operation,versus 0.880,0.915 and 0.548 post-operation,indicating good concurrent efficacy validity and construct validity of SCODI. Conclusions SCODI was a reliable and valid instrument for measuring the necessity and effect of operation in Chinese patients with chronic LBP induced by LCCS disability.%目的 研究简式中文版Oswestry功能障碍指数(SCODI)评定腰骶部慢性骨筋膜间隔综合征(LCCS)所致下背痛(LBP)患者手术疗效的信度及效度.方法 共选取140例LCCS所致LBP患者,根据其病情给予腰

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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

  3. 桃红四物汤治疗兔早期筋膜间隔综合征的疗效观察及作用机制研究%Experimental research on curative effect and mechanism of action of Taohong Siwu Tang(桃红四物汤)for treatment of early compartment syndromes in rabbits

    Institute of Scientific and Technical Information of China (English)

    赵佳盛; 张耘

    2015-01-01

    腓深神经纤维变性、水肿,核固缩、减少或消失,神经束膜增厚。药物组造模侧胫前肌肌纤维萎缩、横纹模糊,组织间隙增宽,可见少量炎性细胞浸润;腓深神经纤维水肿,少量变性,神经束膜增厚。结论:桃红四物汤对于早期筋膜间隔综合征具有一定的防治作用,其作用机制可能是通过降低血液流变学指标,改善血液及微循环状态。%Objective:To study the curative effect and mechanism of action of Taohong Siwu Tang(桃红四物汤)for treatment of early compartment syndromes in rabbits.Methods:Twenty adult male big -eared New Zealand rabbits were made into compartment syndromes models in posterior limbs through compression with pneumatic tourniquet,and then the rabbits were randomly divided into drug group and model group,10 cases in each group.The rabbits in drug group were intragastric administrated with Taohong Siwu Tang(7 ml at a time);while the others in model group were intragastric administrated with the same dose of normal saline,twice a day for 1 consecutive week.The general state of health,degree of leg swelling,anterior compartment pressure and hemorheology indexes of rabbits were observed before the modeling and at 12 hrs and 1,2,4 and 7 days after the modeling respectively.All the rabbits were executed at 7 days after the modeling,and their anterior tibial muscles and deep peroneal nerves were fetched out and sectioned for inspection under the light microscope.Results:During the experiment,the rabbits in model group presented with depressed spirit,decreased eating and normal stool,and 1 rabbit died.The rabbits in drug group presented with normal spirit,normal eating and sloppy stool,and 1 rabbit died.There was statistical difference in leg swelling degree between different timepoints,in other words,there was time effect(F =244.260,P =0.000).There was statistical difference in leg swelling degree between the two groups in general,in other words

  4. Catastrophic primary antiphospholipid syndrome

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. 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

    Science.gov (United States)

    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...

  6. Abdominal neurenteric cyst

    Institute of Scientific and Technical Information of China (English)

    Radoje (C)olovi(c); MarJan Micev; Miodrag Jovanovi(c); Slavko Mati(c); Nikica Grubor; Henry Dushan E Atkinson

    2008-01-01

    immunoexpression, and the respiratory epithelium revealed a CK8 and CK18 immunoprofile without CK 10/13 positive elements, though neither CEA or AFP positive cells were found. To our knowledge, this is the first reported case of an abdominally located neurenteric cyst with no associated spinal anomalies.

  7. Abdominal pain: a synthesis of recommendations for its correct management

    Directory of Open Access Journals (Sweden)

    Daniela Tirotta

    2015-05-01

    Full Text Available Abdominal pain represents one of the most important diagnostic challenges for any physician and its correct interpretation and management require a proper systematic approach and sometimes an urgent action. Moreover the guidelines that can be referred to for indications about the most adequate management procedures are few and often focused only on radiologic management. Consequently, the approach to abdominal pain is often empirical. Therefore, we propose a review of the literature on the diagnosis of abdominal pain, which may contribute to improve the diagnosis and treatment of this complex condition through a systematic review of the evidences available in this field. As to our methodology, we conducted an extensive search in the main guideline databases (SIGN, ICSI, NICE, National Guideline Cleringhouse, CMA Infobase, NZ Guidelines Group, National System Guidelines, Clinical Practice Guidelines Portal, eGuidelines, using as key words abdominal pain and abdominalgia. The guidelines were assessed according to the 2010 Italian version of the AGREE (Appraisal of Guidelines, Research and Evaluation II methodology. Afterwards we formulated our main recommendations associated with the corresponding levels of evidence and focused our attention on some grey areas, which we investigated with further research using Medline and the main systematic review databases (Cochrane database. The four main grey areas investigated were: hospital admission criteria, prognostic stratification, need for analgesic treatment and possibility of attributing abdominalgia to an abdominal pain syndrome. We then formulated our consesus-based recommendations on the grey areas. Abdominal pain management remains a complex issue for internists. As with other diagnostic challenges, it would be advisable to develop additional guidelines based on a multidisciplinary approach and not only focused on radiological management.

  8. A clinical dilemma: abdominal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    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

  9. [Abdominal pregnancy care. Case report].

    Science.gov (United States)

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino

    2008-10-01

    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  10. Acute Pancreatitis Concomitant Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Okay Abacı

    2013-03-01

    Full Text Available Acute pancreatitis is an inflammatory syndrome with unpredictable progression to systemic inflammation and multi-organ dysfunction. As in our case rarely, acute pancreatitis can be presented with the coexistance of acute coronary syndrome. To prevent a misdiagnosis of acute situation presented with chest or abdominal pain, physicians must be aware for coexisting pathophysiologies and take into account the differential diagnosis of all life-threatening causes such as cardiac ischemia or acute abdominal situations.

  11. The muscle pattern of the Drosophila abdomen depends on a subdivision of the anterior compartment of each segment.

    Science.gov (United States)

    Krzemien, Joanna; Fabre, Caroline C G; Casal, José; Lawrence, Peter A

    2012-01-01

    In the past, segments were defined by landmarks such as muscle attachments, notably by Snodgrass, the king of insect anatomists. Here, we show how an objective definition of a segment, based on developmental compartments, can help explain the dorsal abdomen of adult Drosophila. The anterior (A) compartment of each segment is subdivided into two domains of cells, each responding differently to Hedgehog. The anterior of these domains is non-neurogenic and clones lacking Notch develop normally; this domain can express stripe and form muscle attachments. The posterior domain is neurogenic and clones lacking Notch do not form cuticle; this domain is unable to express stripe or form muscle attachments. The posterior (P) compartment does not form muscle attachments. Our in vivo films indicate that early in the pupa the anterior domain of the A compartment expresses stripe in a narrowing zone that attracts the extending myotubes and resolves into the attachment sites for the dorsal abdominal muscles. We map the tendon cells precisely and show that all are confined to the anterior domain of A. It follows that the dorsal abdominal muscles are intersegmental, spanning from one anterior domain to the next. This view is tested and supported by clones that change cell identity or express stripe ectopically. It seems that growing myotubes originate in posterior A and extend forwards and backwards until they encounter and attach to anterior A cells. The dorsal adult muscles are polarised in the anteroposterior axis: we disprove the hypothesis that muscle orientation depends on genes that define planar cell polarity in the epidermis.

  12. Abdominal wall hernia and pregnancy

    DEFF Research Database (Denmark)

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

    2015-01-01

    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......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 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...

  13. Abdominal actinomycosis mimicking acute appendicitis.

    Science.gov (United States)

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  14. Molecular Characterization of Plant Prevacuolar and Endosomal Compartments

    Institute of Scientific and Technical Information of China (English)

    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.

  15. 14 CFR 23.853 - Passenger and crew compartment interiors.

    Science.gov (United States)

    2010-01-01

    ...) Interior ceiling panels, interior wall panels, partitions, galley structure, large cabinet walls, structural flooring, and materials used in the construction of stowage compartments (other than...

  16. Blunt abdominal trauma in sports.

    Science.gov (United States)

    Rifat, Sami F; Gilvydis, Rimas P

    2003-04-01

    Abdominal injuries are rare in sports, but when they do occur it is important that the physician recognize the warning signs of potentially life-threatening injury to the liver, spleen, or hollow abdominal viscera. Though the sports medicine physician may not always provide definitive treatment of many of these conditions, he or she should be familiar with the preferred diagnostic modalities and latest treatment options. This information is not only essential to appropriately participate in treatment decisions, but is also important in order to make return-to-play determinations.

  17. [Gallstone ileus. Abdominal CT usefulness].

    Science.gov (United States)

    Sukkarieh, F; Brasseur, P; Bissen, L

    2004-06-01

    The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

  18. CT appearances of abdominal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. Diagnosis in acute abdominal pain and ongoing abdominal sepsis

    NARCIS (Netherlands)

    Kiewiet, J.J.S.

    2016-01-01

    Acute abdominal pain is a common reason for presentation at the emergency department. To establish a timely and adequate diagnosis, doctors use the pattern of complaints and physical examination as the basis for the evaluation of a patient. In this thesis we conducted a study that showed that surgeo

  20. Premature loss of bone remodeling compartment canopies is associated with deficient bone formation

    DEFF Research Database (Denmark)

    Jensen, Pia Rosgaard; Andersen, Thomas Levin; Søe, Kent;

    2011-01-01

    A remarkable property of bone remodeling is that osteoblasts form bone matrix exactly where and when osteoclasts have removed it. The bone remodeling compartment (BRC) canopies that cover bone surfaces undergoing remodeling, were proposed to be critical players in this mechanism. Here, we provide...... support to this hypothesis by analyzing the changes in prevalence of BRC canopies during the progress of the remodeling cycle in a cohort of healthy individuals and in patients with endogenous Cushing's syndrome (CS), and by relating these changes in prevalence with the extent of bone forming surfaces...

  1. Chronic intestinal pseudoobstruction syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Yeon, Kyung Mo; Seo, Jeong Kee; Lee, Yong Seok [Seoul National University Children' s Hospital, Seoul (Korea, Republic of)

    1992-03-15

    Chronic intestinal pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel, and may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distension and deflection difficulty. Five had urinary bladder distension. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepses within one year. All had gaseous distension of small and large bowel on abdominal films. In small bowel series, consistent findings were variable degree of dilatation, decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  3. Arnebia euchroma ointment can reduce abdominal fat thickness and abdominal circumference of overweight women: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Mansour Siavash

    2016-01-01

    Full Text Available Background: Obesity is a worldwide health problem which is associated with a lot of complications. One of these comorbidities is the metabolic syndrome that is in correlation with abdominal fat thickness and waist circumference. Various methods were used to reduce abdominal fat thickness such as liposuction. A noninvasive method is the topical agent. In this study, we investigated the effectiveness of Arnebia euchroma (AE ointment on the abdominal fat thickness. Materials and Methods: This study was a double-blind clinical trial which was done at the endocrinology clinic in Khorshid Hospital, Isfahan, Iran, in 2014. After explaining the procedure and obtaining informed consent, the candidates were randomly divided into the case and control groups. The participants of the case and control groups applied AE ointment or placebo for 6 weeks on their abdominal area. Body mass index, waist and buttock circumference, and abdominal fat thickness were measured in both case and control groups at their first visit and then at the next 2, 4, and 6 weeks. We used t-test for comparing parametric variables between groups, paired t-test for changes from baseline to final, and repeated measure ANOVA for changes at different steps. Results: Sixty female candidates participated in this study (thirty in each group. Ten patients left the study and fifty participants finished the trial. At the end of the study, participants had a significant weight loss (2.96 ± 1.6 kg, P < 0.001 that was slightly more in the case group (3.15 ± 1.5 kg vs. 2.75 ± 1.7, P = 0.375. Abdominal circumference also decreased significantly in the participants (11.3 ± 6.7 cm, P < 0.001, but the changes were more significant in the case group (13.9 vs. 6.5 cm, P = 0.004. Similarly, abdominal fat thickness decreased significantly in the participants (2.3 ± 1.1 cm, P < 0.001, although changes were not significantly different between two groups (2.53 vs. 2.04 cm, P = 0.139. Conclusion: Topical

  4. Clinical management of abdominal trauma

    Institute of Scientific and Technical Information of China (English)

    FANG Guo-en; LUO Tian-hang; DU Cheng-hui; BI Jian-wei; XUE Xu-chao; WEI Guo; WENG Zhao-zhang; MA Li-ye; HUA Ji-de

    2008-01-01

    Objective: To improve the prognosis of patients with abdominal trauma. Methods: Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years ranging from 3-82 years. All abdominal traumas consisted of closed traumas 360 cases, 86.7% and open traumas 55 cases, 13.3%. Results: Atotal of 407 cases 98.1% were fully recovered from trauma and the other 8 cases 1.9% died of multiple injuries. The mean injury severity score ISS of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds 6 cases, pancreatic fistula 2 cases and intestinal fistula 1 case. All these postoperative complications were cured by the conservative treatment. Conclusion: Careful case history inquisition and physical examination are the basic methods to diagnose abdomi- nal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.

  5. Chronic Abdominal Pain in Children

    NARCIS (Netherlands)

    C.F.M. Gijsbers (Carolien)

    2012-01-01

    textabstractRecurrent abdominal pain (RAP) was first defined in 1958 by Apley as “at least 3 bouts of pain, severe enough to affect activities, over a period of at least 3 months” (1). This was a landmark publication with great impact, showing, that emotional disturbances played a role in many patie

  6. Economic costs of abdominal obesity

    DEFF Research Database (Denmark)

    Højgaard, Betina; Olsen, Kim Rose; Søgaard, Jes

    2008-01-01

    BACKGROUND: To examine the relationship between waist circumference and future health care costs across a broad range of waist circumference values based on individual level data. METHOD: A prospective cohort of 31,840 subjects aged 50-64 years at baseline had health status, lifestyle and socio-e...... be a potential for significant resource savings through prevention of abdominal obesity....

  7. Inflammatory characteristics of distinct abdominal adipose tissue depots relate differently to metabolic risk factors for cardiovascular disease Distinct fat depots and vascular risk factors

    NARCIS (Netherlands)

    Kranendonk, Mariette E. G.; van Herwaarden, Joost A.; Stupkova, Tereza; de Jager, Wilco; Vink, Aryan; Moll, Frans L.; Kalkhoven, Eric; Visseren, Frank L. J.

    2015-01-01

    Objective: Abdominal obesity is associated with insulin resistance and metabolic syndrome. However, specific contributions of distinct adipose tissue (AT) depots to metabolic complications of obesity are still unclear. In this study, the inflammatory profile of four distinct abdominal AT-depots and

  8. Abdominal aortic aneurysm repair - open - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000240.htm Abdominal aortic aneurysm repair - open - discharge To use the sharing features ... References Orandi BJ, Black JH. Open repair of abdominal aortic aneurysms. In: Cameron JL, Cameron AM, eds. Current Surgical ...

  9. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    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 ...

  10. 脑源性神经营养因子在肠易激综合征患者腹痛中的作用%The role of brain-derived neurotrophic factor in the abdominal pain of irritable bowel syndrome patients

    Institute of Scientific and Technical Information of China (English)

    于岩波; 左秀丽; 陈飞雪; 董艳艳; 李延青

    2011-01-01

    Objective To investigate the correlation between the expression changes of brain-derived neurotrophic factor (BDNF) in colon mucosa and abdominal pain in irritable bowel syndrome (IBS). The density of nerve fiber in colon mucosa and ultrastructural alterations of nerve fiber in IBS were also observed. Methods From September 2008 to January 2010,the IBS patients who visited the department of gastroenterology of our hospital and met the Rome Ⅲ diagnosis criteria were selected and divided into IBS with diarrhea (D-IBS) and IBS with constipation (C-IBS) according to their clinical features. The patients with colon polyps detected by colonoscopy in our hospital were selected as control group. All subjects were asked to fill in Self-Rating abdominal pain or abdominal uncomfortable Scale according to abdominal symptom in the last 2 weeks before visit and underwent colonoscopy. Four biopsy specimens were taken from the colon mucosa of rectosigmoid junction. Ofwhich,two specimens were for protein isolation and detection of BDNF expression level,one specimen was used for PGP 9. 5 immunohistochemistry staining in paraffin slices. Another specimen was used to observe the ultrastructure changes of nerve fiber in colon mucosa under transmission electron microscopy. Results Total 40 IBS patients were enrolled in this study,of those 21 were D-IBS patients,19 were C-IBS patients,and 21 were controls. The abdominal pain severity score and frequency score of IBS patients were (2. 3±0. 8) and (2. 1±0. 7),which were significantly higher than those of control group (0. 4±0. 7 and 0. 3±0. 5,P<0. 001). Compared with the control group,the BDNF expression in colon mucosa was significantly elevated in IBS patients (P= 0. 003 ),and which correlated with the severity and frequency of abdominal pain/discomfort (r=0. 57,P<0. 001and r=0. 46,P= 0. 003,respectively). The immunohistochemistry result indicated that the nerve fiber density in colon mucosa of IBS patients was significantly

  11. 49 CFR 179.220-9 - Compartment tanks.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Compartment tanks. 179.220-9 Section 179.220-9... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW and 115AW) § 179.220-9 Compartment tanks....

  12. 49 CFR 179.200-9 - Compartment tanks.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Compartment tanks. 179.200-9 Section 179.200-9... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW and 115AW) § 179.200-9 Compartment tanks....

  13. 46 CFR 169.625 - Compartments containing diesel machinery.

    Science.gov (United States)

    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,...

  14. [Primary actinomycosis of the abdominal wall. Description of 2 cases and review of the literature].

    Science.gov (United States)

    García García, J C; Núñez Fernández, M J; Cerqueiro González, J M; García Martín, C; Rodríguez García, J C; Anibarro García, L; de Lis Muñoz, J M; Piñeiro Gómez-Durán, L

    2001-02-01

    We report two cases of isolated abdominal wall actinomycosis and review 18 previously reported cases to further characterize the clinical findings and the therapeutic management of this syndrome. This diagnosis would be advocated in patients with a palpable abdominal mass of subacute appearance with a previous history of digestive medical illness, diabetes, abdominal surgery, or prolonged IUD use. In contrast with other actinomycosis locations, remarkable data were a more elevated mean age of patients; a female predominance; a prevalent location of mass in abdominal lower left quadrant; and a shorter duration of symptomatology before to diagnosis. The CT is the first choice for imaging study and percutaneous needle aspiration would be recommended for definite diagnosis. The long-term antibiotic therapy, with or without percutaneous drainage, is the first treatment choice because is very effective and made unnecessary a more invasive surgical management. The prognosis is excellent with adequated treatment.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Superman play and pediatric blunt abdominal trauma.

    Science.gov (United States)

    Machi, J M; Gyuro, J; Losek, J D

    1996-01-01

    Two pediatric patients with life-threatening intra-abdominal injuries associated with Superman play are presented. The cases illustrate the importance of knowing the mechanism of injury in the assessment of children with blunt abdominal trauma. The diagnostic value of liver enzymes and the controversies surrounding the radiographic assessment of pediatric blunt abdominal trauma are presented.

  17. Intra-abdominal pressure and possible ways of its drug correction after emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Людмила Василівна Новицька-Усенко

    2015-11-01

    Full Text Available Introduction. Postoperative disorders of gastrointestinal tract (GIT motility are often after abdominal operations. Postoperative enteroparesis is usually accompanied by the raise of intra-abdominal pressure (IAP.Materials and methods. After approval of research by bioethics committee and informed consent 52 patients were prospectively divided in 2 groups depending on the type of postoperative intensive care. Patients underwent operations on abdominal cavity by laparotomy incision on the subject of peritonitis. Patient of the 1 (control group (n=27 after operation received stimulation of GIT with metoclopramide and simethicone.  In the 2 group (n=25 patients received metoclopramide and simethicone. Patients were comparable on age, sex, concomitant pathology, ASA class (IIE-IIIE and the type of operative intervention (laparotomy on the subject of peritonitis. IAP level was studied before operation and at 1,2,3 days after it. IAP was measured by indirect method trough the urinary bladder. The values recommended by the World society of abdominal compartment syndrome were considered as the normal IAP level.  Perfuse pressure (PP in abdominal cavity was calculated by formula: PP=MAP-ICP where MAP – mean arterial pressure. There were also studied indices of the central and peripheral hemodynamics, inflammation markers (leukocytes, fibrinogen level, IL-1α, TNFα, IL-10, leukocytic index of intoxication was calculated. The final point of research was 28 day after operation when we evaluated mortality and life quality on Rancho Los Amigos scale.Results and discussion. We registered the raise of IAP in 63.1% of patients. The value of intra-abdominal pressure exceeded an upper limit of the normal one by 58,5% (р <0,001. Among patients with high IAP 83% had intra-abdominal hypertension (IAH of 1 degree, 17% - of 2 degree.  The development of 3 and 4degree IAH were not observed before operation. PP remained within the normal.Correlative analysis

  18. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    Directory of Open Access Journals (Sweden)

    Ali Ridha

    2017-01-01

    Full Text Available Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003. This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.

  19. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    Science.gov (United States)

    Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel

    2017-01-01

    Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215

  20. Percutaneous Release of the First Dorsal Extensor Compartment: A Cadaver Study

    Science.gov (United States)

    Güleç, Ali; Türkmen, Faik; Toker, Serdar

    2016-01-01

    Background: To evaluate the efficiency of the percutaneous 18-G needle technique in releasing the fibro-osseous sheath over the first dorsal extensor compartment of the hand. Methods: Using anatomic landmarks, percutaneous release was performed with an 18-G needle on 48 wrists of 24 cadavers. The specimens were then dissected and examined for the completeness of the first dorsal extensor compartment release and any tendon or neurovascular injuries. The tunnel length, number of abductor pollicis longus and extensor pollicis brevis tendons, presence of an intertendinous septum, and the effects of these parameters on percutaneous release were evaluated. Results: Percutaneous release was performed on all of the wrists, and the evaluation of the adequacy of release revealed 25 complete releases, 21 partial releases, and 2 missed releases. There were 19 cases of tendon complications. No neurovascular injuries were noted. The mean tunnel length was 2.66 ± 30 cm, and the mean number of tendons was 2.75 ± 0.86. A septum was present in 33.3% of cases. Tunnel length and tendon number had no statistically significant effect on release, whereas the presence of a septum was significantly associated with inadequate tunnel release and the development of tendon complications. Conclusions: Percutaneous release of the first dorsal extensor compartment using an 18-G needle was associated with high rates of incomplete release and tendon damage in the presence of an intertendinous septum. Further study is required under ultrasound guidance to determine the usefulness of percutaneous release in the first dorsal extensor compartment. Clinical Relevance: Release with a percutaneous needle tip in De Quervain’s syndrome may provide the advantages of better cosmetic results with less scar formation and an early return to work. PMID:27826460

  1. The Diagnostic Value of Intra-abdominal Pressure in Patients with Blunt Acute Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Huseyin Narci

    2012-06-01

    Full Text Available Purpose:The objective of this study was to determine the diagnostic value of intra-abdominal pressure measurement in blunt abdominal trauma patients. Method: A prospective study was performed in 49 patients with blunt trauma in our university hospital for 1 years. Patients were randomly into two groups as intra-abdominal trauma (n=28 and extraabdominal trauma (n=21 groups. Intra-abdominal pressures was measured an classified as normal (10 cm H2O or less, elevated (more than 10 cm H2O determined indirectly. Results: No significant differences were found between abdominal trauma and extra-abdominal trauma groups from the point of intra-abdominal pressure (IAP. One the other hand, in abdominal trauma group; significant differences were observed between operated patients. Intra-abdominal bleeding was found in 10 patients and all of them elevated IAP values (exceeding 16 cm H2O. For determining the intra-abdominal injury, IAP had a sensitivity of 93%, specificity 38% in patients. Conclusion: IAP exceeding 16 cm H2O with blunt abdominal trauma patients abdominal trauma can be detected. It is thought that IAP, indirect monitoring of abdominal trauma patients is a reproducible, scientific guide and simple method.To determine the efficacy of the measurement of intra-abdominal pressure in blunt abdominal trauma patients, further studies should be done. [Cukurova Med J 2012; 37(3.000: 157-161

  2. Acupuncture Treatment of Abdominal Pain

    Institute of Scientific and Technical Information of China (English)

    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.

  3. Mediterranean diet and the metabolic syndrome

    NARCIS (Netherlands)

    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. DUMPING SYNDROME IN A YOUNG-CHILD

    NARCIS (Netherlands)

    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

  5. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    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 

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

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    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.

  7. Stochastic Turing patterns: analysis of compartment-based approaches.

    Science.gov (United States)

    Cao, Yang; Erban, Radek

    2014-12-01

    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.

  8. Stochastic Turing Patterns: Analysis of Compartment-Based Approaches

    KAUST Repository

    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.

  9. Urgent Abdominal Re-Explorations

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    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

  10. Case report 509: Proteus syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Burnstein, M.I.; Kottamasu, S.R.; Katz, M.E.; Weiss, L.

    1988-10-01

    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.

  11. Dynamics of the Establishment of Multinucleate Compartments in Fusarium oxysporum

    Science.gov (United States)

    Shahi, Shermineh; Beerens, Bas; Manders, Erik M. M.

    2014-01-01

    Nuclear dynamics can vary widely between fungal species and between stages of development of fungal colonies. Here we compared nuclear dynamics and mitotic patterns between germlings and mature hyphae in Fusarium oxysporum. Using fluorescently labeled nuclei and live-cell imaging, we show that F. oxysporum is subject to a developmental transition from a uninucleate to a multinucleate state after completion of colony initiation. We observed a special type of hypha that exhibits a higher growth rate, possibly acting as a nutrient scout. The higher growth rate is associated with a higher nuclear count and mitotic waves involving 2 to 6 nuclei in the apical compartment. Further, we found that dormant nuclei of intercalary compartments can reenter the mitotic cycle, resulting in multinucleate compartments with up to 18 nuclei in a single compartment. PMID:25398376

  12. Forests and Forest Cover - Ozark National Forest Service Compartments (polygon)

    Data.gov (United States)

    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...

  13. 7 CFR 58.510 - Rooms and compartments.

    Science.gov (United States)

    2010-01-01

    ....510 Rooms and compartments. (a) Processing operations with open cheese vats should be separated from... techniques shall be provided for the propagation and handling of starter cultures. All necessary...

  14. Condensation within small compartments during design basis accidents

    Energy Technology Data Exchange (ETDEWEB)

    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)

  15. Modulatory compartments in cortex and local regulation of cholinergic tone.

    Science.gov (United States)

    Coppola, Jennifer J; Ward, Nicholas J; Jadi, Monika P; Disney, Anita A

    2016-09-01

    Neuromodulatory signaling is generally considered broad in its impact across cortex. However, variations in the characteristics of cortical circuits may introduce regionally-specific responses to diffuse modulatory signals. Features such as patterns of axonal innervation, tissue tortuosity and molecular diffusion, effectiveness of degradation pathways, subcellular receptor localization, and patterns of receptor expression can lead to local modification of modulatory inputs. We propose that modulatory compartments exist in cortex and can be defined by variation in structural features of local circuits. Further, we argue that these compartments are responsible for local regulation of neuromodulatory tone. For the cholinergic system, these modulatory compartments are regions of cortical tissue within which signaling conditions for acetylcholine are relatively uniform, but between which signaling can vary profoundly. In the visual system, evidence for the existence of compartments indicates that cholinergic modulation likely differs across the visual pathway. We argue that the existence of these compartments calls for thinking about cholinergic modulation in terms of finer-grained control of local cortical circuits than is implied by the traditional view of this system as a diffuse modulator. Further, an understanding of modulatory compartments provides an opportunity to better understand and perhaps correct signal modifications that lead to pathological states.

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

    Science.gov (United States)

    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.

  17. Dynamic changes in thrombin generation in abdominal sepsis in mice.

    Science.gov (United States)

    Wang, Yongzhi; Braun, Oscar O; Zhang, Su; Luo, Lingtao; Norström, Eva; Thorlacius, Henrik

    2014-10-01

    Systemic inflammatory response syndrome and severe infections are associated with major derangements in the coagulation system. The purpose of this study was to examine the dynamic alterations in thrombin generation in abdominal sepsis. Abdominal sepsis was induced by cecal ligation and puncture (CLP) in C57/Bl6 mice. Cecal ligation and puncture caused a systemic inflammatory response, with neutrophil recruitment and tissue damage in the lung as well as thrombocytopenia and leukocytopenia. Thrombin generation, coagulation factors, lung histology, and myeloperoxidase activity was determined 1, 3, 6, and 24 h after induction of CLP. It was found that thrombin generation was increased 1 h after CLP and that thrombin generation started to decrease at 3 h and was markedly reduced 6 and 24 h after CLP induction. Platelet-poor plasma from healthy mice could completely reverse the inhibitory effect of CLP on thrombin generation, suggesting that sepsis caused a decrease in the levels of plasma factors regulating thrombin generation in septic animals. Indeed, it was found that CLP markedly decreased plasma levels of prothrombin, factor V, and factor X at 6 and 24 h. Moreover, we observed that CLP increased plasma levels of activated protein C at 6 h, which returned to baseline levels 24 h after CLP induction. Finally, pretreatment with imipenem/cilastatin attenuated the CLP-evoked decrease in thrombin generation and consumption of prothrombin 24 h after CLP induction. Our novel findings suggest that thrombin generation is initially increased and later decreased in abdominal sepsis. Sepsis-induced reduction in thrombin generation is correlated to changes in the plasma levels of coagulation factors and activated protein C. These findings help explain the dynamic changes in global hemostasis in abdominal sepsis.

  18. Peritoneoscopy of the liver after abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Kawaguchi,Kenji

    1983-02-01

    Full Text Available The incidence of intraperitoneal adhesion after abdominal surgery was studied. Peritoneoscopy was performed in 933 patients with liver diseases over the 6 year 5 month period from March 1974 to July 1980. Of the patients, 352 (37.7% had undergone an abdominal operation, and intraperitoneal adhesion was detected in 205 (58.2% of these patients. The liver was not observable in 5 out of 61 patients with adhesions after upper abdominal operations. Whereas, the liver was clearly observable in patients with lower abdominal operations in spite of adhesions. Out of the 581 patients without any abdominal operations, 30 patients (5.2% had adhesions in the abdominal cavity, and 6 of them had extensive adhesions that partially obscured the observation of liver surface. In all patients, peritoneoscopy was performed without complications by avoiding the surgical scar for puncture sites and ensuring a free air lumen before trocar puncture.

  19. Multiple abdominal veins thrombosis secondary to protein s deficiency - a case report.

    Science.gov (United States)

    Kodali, Venkata Umakant; Borra, Seshulakshmi; Mandarapu, Surendra Babu; Sanda, Mallikarjuna Rao; Bolla, Srinivasa Rao

    2014-06-01

    Abdominal venous thrombosis may present either as Budd-Chiari syndrome (BCS) caused by hepatic vein or proximal inferior vena cava (IVC) obstruction or as an extra hepatic portal obstruction (EHPVO) caused by Portal vein thrombosis or mesenteric vein thrombosis, but a mixed involvement is uncommon. Multiple abdominal venous obstructions presenting with thrombosis of hepatic vein, IVC, portal vein and renal vein are very rarely seen . We are reporting a rare case with thrombosis of IVC, hepatic vein, portal vein and renal vein, with protein S and protein C deficiencies, which was managed by giving anticoagulant therapy.

  20. Distal arthrogryposis syndrome

    Directory of Open Access Journals (Sweden)

    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.