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Sample records for recurrent abdominal compartment

  1. Abdominal Compartment Syndrome

    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.

  2. Abdominal Compartment Syndrome in Surgical Patients

    abdominal hypertension and abdominal compartment syndrome, affect ... timely surgical intervention is crucial. Key words: .... On the second postoperative day, he was noted to be restless ... Although surgery is very effective in managing ACS.

  3. Abdominal compartment syndrome with acute reperfusion syndrome

    Maleeva, A.

    2017-01-01

    Abdominal compartment syndrome was recognized clinically in the 19th century when Marey and Burt observed its association with declines in respiratory function. Abdominal compartment syndrome is first used as a medical terminology from Fietsman in a case of ruptured abdominal aortic aneurysm. A condition caused by abnormally increased pressure within the abdomen. Causes of abdominal compartment syndrome include trauma, surgery, or infection. Common symptoms: abdominal distension, fast heart rate, insufficient urine production, or low blood pressure Medical procedure: nasogastric intubation Surgery: laparotomy Specialists: radiologist, primary care provider (PCP), surgeon, and emergency medicine doctor [6, 10]. Keywords: Stomach. Gastroparesis . Diabetes Mellitus [bg

  4. [Intraabdominal hypertension and abdominal compartment syndrome

    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...... medical and surgical conditions increase the intraabdominal volume. When the content exceeds the compliance of the abdominal wall, the IAP rises. Increased IAP affects the functioning of the brain, lungs, circulation, kidneys, and bowel. The treatment of ACS is a reduction of IAP Udgivelsesdato: 2008/2/11...

  5. Enteral Feeding in Abdominal Compartment Syndrome

    Ye. V Grigoryev

    2009-01-01

    Full Text Available Objective: to substantiate the choice of a gastrointestinal tract (GIT function support regimen as a mode for correction of the abdominal compartment syndrome (ACS. Subjects and methods. Forty-three patients with different causes of inadequate GIT function of various origin and ACS (disseminated peritonitis (45%, pancreatitis (24%, and severe concomitant injury (31% were examined. Group 1 (control received complete parenteral nutritional feeding (n=23; APACHE II scores, 21±4; calculated probability of fatal outcome, 33.5%. In Group II (study, complete parenteral feeding in the first 24 hours after stabilization was supplemented with GIT function support with Pepsisorb (Nutricia in doses of 500, 1000, and 1500 ml on days 1, 2, and 3, respectively (n=20; APACHE II scores, 20±6; calculated probability of fatal outcome, 37.1%. During early enteral nutritional support, the SOFA score was significantly less than that in Group 1 on days 2—3; the oxygenation index significantly increased on day 3; the value of intra-abdominal hypertension decreased to the control values. The positive effect of the GIT function support regimen on regression of the multiple organ dysfunction syndrome (MODS was confirmed by the lowered levels of biological markers (von Willebrand factor (WF and endothelin-1 as markers of endothelial damage of MODS. Correlation analysis showed a direct correlation between the markers of endothelial damage and the SOFA scores (r=0.34; p=0.05 for WF and r=0.49;p=0.03 for endothelin. Conclusion. The GIT function support regimen via early enteral alimentation with Peptisorb, which was initiated in the first 24 hours after admission, is able to level off the manifestations of the early stages of the abdominal compartment syndrome, with the acceptable values of oxygen balance and water-electrolyte and osmotic homeostasis being achieved. Key words: abdominal compartment syndrome, nutritional support, biological markers, oxygenation index

  6. Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome.

    Roberts, Derek J; Ball, Chad G; Kirkpatrick, Andrew W

    2016-04-01

    This article reviews recent developments related to intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) and clinical practice guidelines published in 2013. IAH/ACS often develops because of the acute intestinal distress syndrome. Although the incidence of postinjury ACS is decreasing, IAH remains common and associated with significant morbidity and mortality among critically ill/injured patients. Many risk factors for IAH include those findings suggested to be indications for use of damage control surgery in trauma patients. Medical management strategies for IAH/ACS include sedation/analgesia, neuromuscular blocking and prokinetic agents, enteral decompression tubes, interventions that decrease fluid balance, and percutaneous catheter drainage. IAH/ACS may be prevented in patients undergoing laparotomy by leaving the abdomen open where appropriate. If ACS cannot be prevented with medical or surgical management strategies or treated with percutaneous catheter drainage, guidelines recommend urgent decompressive laparotomy. Use of negative pressure peritoneal therapy for temporary closure of the open abdomen may improve the systemic inflammatory response and patient-important outcomes. In the last 15 years, investigators have better clarified the pathogenesis, epidemiology, diagnosis, and appropriate prevention of IAH/ACS. Subsequent study should be aimed at understanding which treatments effectively lower intra-abdominal pressure and whether these treatments ultimately affect patient-important outcomes.

  7. Abdominal Compartment Syndrome Secondary to Chronic Constipation

    Helene Flageole

    2011-01-01

    Full Text Available Abdominal compartment syndrome (ACS is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not.

  8. Recent advances in the management of abdominal compartment syndrome

    Saleem, T.B.; Ahmed, I.

    2004-01-01

    Abdominal compartment syndrome is a systemic syndrome involving derangement in cardiovascular hemodynamics, respiratory and renal function as a result of sustained increase in intra-abdominal pressure. This results in multi-organ failure requiring prompt action and treatment. Presentation can be acute, chronic and acute on chronic. Initial diagnosis is clinical, confirmed by measurement of urinary bladder pressure. Treatment is abdominal decompression by laparostomy and delayed abdominal closure. Awareness among the surgeons has increased because laparoscopy has resulted in determination of intra-abdominal pressure as a readily measurable quantity. They have been able to appreciate the benefit of abdominal decompression by performing repeated planned laparotomies for trauma. (author)

  9. A wolf in wolf's clothing the abdominal compartment syndrome

    abdomen. These findings are consistent with the diagnosis of intra-abdominal compartment syndrome. In 1 case trauma was remote from the abdomen .... although they tend to develop most often in those who have undergone major vascular operations or suffered abdominal trauma. The effects of the pressure on the bowel ...

  10. Bladder distension as a cause of abdominal compartment syndrome

    Yasir, M.; Hoda, M.Q.

    2018-01-01

    Abdominal compartment syndrome (ACS) is increasingly identified in critically ill patient and its harmful effects are well documented. The disparity among the pressure, volume in abdominal cavity and its contents, results in ACS. The actual incidence of ACS is not known. However, it has been observed predominantly in patients with severe blunt and penetrating abdominal trauma, ruptured abdominal aortic aneurysms, retro- and intra-peritoneal hemorrhage, pneumoperitoneum, neoplasm, pancreatitis, ascites and multiple bone fracture. We present a case of 40-year female who underwent emergency cesarean section and developed abdominal compartment syndrome due to urinary bladder distension secondary to blockade of urinary catheter with blood clots. This is a very unusual cause of ACS. (author)

  11. A novel nonoperative approach to abdominal compartment syndrome after abdominal wall reconstruction.

    Hasan, Zeenat R; Sorensen, G Brent

    2013-01-01

    Intraabdominal hypertension and abdominal compartment syndrome have been increasingly recognized as significant causes of morbidity and mortality in both medical and surgical patients. The gold standard remains surgical intervention; however, nonoperative approaches have been investigated less. Here, we describe the successful treatment of a severe acute case by intubation, nasogastric decompression, and paralysis--a novel approach not previously described in the literature. After the patient underwent laparoscopic bilateral component separation and repair of a large recurrent ventral hernia with a 20 30-cm Strattice mesh (LifeCell Corp, Branchburg, NJ), acute renal failure developed within 12 hours postoperatively, and was associated with oliguria, hyperkalemia, and elevated peak airway and bladder pressures. The patient was treated nonoperatively with intubation, nasogastric tube decompression, and paralysis with a vecuronium drip. Rapid reversal was seen, avoiding further surgery. Within 2 hours after intubation and paralysis, our patient's urine output improved dramatically with an initial diuresis of approximately 1 L, his bladder pressures decreased, and within 12 hours his creatinine level had normalized. Although surgical intervention has traditionally been thought of as the most effective--and thus the gold standard--for abdominal compartment syndrome, this preliminary experience demonstrates nonoperative management as highly efficacious, with the added benefit of decreased morbidity. Therefore, nonoperative management could be considered first-line therapy, with laparotomy reserved for refractory cases only. This suggests a more complex pathology than the traditional teaching of congestion and edema alone.

  12. Perforated peptic ulcer associated with abdominal compartment syndrome.

    Lynn, Jiun-Jen; Weng, Yi-Ming; Weng, Chia-Sui

    2008-11-01

    Abdominal compartment syndrome (ACS) is defined as an increased intra-abdominal pressure with adverse physiologic consequences. Abdominal compartment syndrome caused by perforated peptic ulcer is rare owing to early diagnosis and management. Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS. We report a case of perforated peptic ulcer associated with ACS. A 74-year-old man with old stroke and dementia history was found to have distended abdomen, edema of bilateral legs, and cyanosis. Laboratory tests revealed deterioration of liver and kidney function. Abdominal compartment syndrome was suspected, and image study was arranged to find the cause. The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls. Emergent laparotomy was performed. Perforated peptic ulcer was noted and the gastrorrhaphy was done. The symptoms, and liver and kidney function improved right after emergent operation.

  13. Abdominal compartment syndrome following abdominoplasty: A case report and review

    Arash Izadpanah

    2014-01-01

    Full Text Available Abdominoplasty is among the most commonly performed aesthetic procedures in plastic surgery. Despite high complication rate, abdominal contouring procedures are expected to rise in popularity with the advent of bariatric surgery. Patients with a history of gastric bypass surgery have an elevated incidence of small bowel obstruction from internal herniation, which is associated with non-specific upper abdominal pain, nausea, and a decrease in appetite. Internal hernias, when subjected to elevated intra-abdominal pressures, have a high-risk of developing ischemic bowel. We present a case report of patient with previous laparoscopic Roux-en-y gastric bypass who developed acute ischemic bowel leading to abdominal compartment syndrome following abdominoplasty. To the best of our knowledge, this is the first reported case in the literature. We herein emphasise on the subtle symptoms and signs that warrant further investigations in prospective patients for an abdominal contouring procedure with a prior history of gastric bypass surgery.

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

    Wei Lai

    2016-04-01

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

  15. Recurrent desmoid tumor of the abdominal wall | Toughrai | Pan ...

    Desmoid tumors most often occur in abdominal wall. Their tendency to recur lead to repeated operations which can make the abdominal wall reconstruction difficult. We report a 28-year-old female history. The patient was referred to our hospital for a recurrent desmoid tumor of the abdominal wall. The tumor was totally ...

  16. A case of abdominal compartment syndrome derived from simple elongated sigmoid colon in an elderly man

    Masaaki Shida

    2016-01-01

    Discussion and conclusion: Considering the increase in the aging population, we must bear in mind that abdominal compartment syndrome may occur in simple elongated sigmoid colon without other risk factors.

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

    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.

  18. Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain

    Wewer, Anne Vibeke; Strandberg, C; Pærregaard, Anders

    1997-01-01

    We report on our experience with routine abdominal ultrasonography in 120 children (aged 3-15 years) with recurrent abdominal pain, in order to determine the diagnostic value of this investigation. Eight children (7%) revealed sonographic abnormalities: gallbladder stone (n = 2), splenomegaly (n...... = 1) and urogenital abnormalities (n = 5). The recurrent abdominal pain could be explained by these findings in only two (may be three) cases. CONCLUSION: The diagnostic value of abdominal ultrasonography in unselected children with recurrent abdominal pain is low. However, the direct visualization...... of the abdominal structures as being normal may be helpful to the parents and the child in their understanding and acceptance of the benign nature of recurrent abdominal pain....

  19. Interventional and surgical management of abdominal compartment syndrome in severe acute pancreatitis.

    Dambrauskas, Zilvinas; Parseliūnas, Audrius; Maleckas, Almantas; Gulbinas, Antanas; Barauskas, Giedrius; Pundzius, Juozas

    2010-01-01

    Management of the abdominal compartment syndrome during severe acute pancreatitis by the open abdomen method is associated with considerable morbidity and resource utilization. Thus, the aim of this study was to evaluate the safety and efficacy of the ultrasound-guided percutaneous interventions and/or minimally invasive surgery in the treatment of abdominal compartment syndrome. Forty-four patients with severe acute pancreatitis were enrolled into a prospective study and treated according to the standard management protocol. Interventional and/or surgical management of abdominal compartment syndrome was employed in 6 (13.6%) cases. In the context of this study, we assessed the feasibility and effectiveness of subcutaneous fasciotomy of the anterior m. rectus abdominis sheath, as well as the role of ultrasound-guided drainage of intra-abdominal and peripancreatic fluid collections in the management of abdominal compartment syndrome. Subcutaneous fasciotomy of the anterior m. rectus sheath and ultrasound-guided drainage of intra-abdominal and peripancreatic fluid collections seem to be safe (minor risk of bleeding or infection, closed abdomen, and easy care for the patient) and effective (resulted in a sustained decrease of intra-abdominal pressure to 13-16 mm Hg and regression of organ failures after intervention). Subcutaneous anterior m. rectus fasciotomy may appear to be beneficial in case of refractory abdominal compartment syndrome avoiding morbidity associated with the open abdomen technique. Both the subcutaneous fasciotomy and ultrasound-guided drainage of intra-abdominal and/or peripancreatic fluid collections seem to be safe and effective alternatives in the management of abdominal compartment syndrome; however, prospective studies are needed to further evaluate their clinical role.

  20. Recurrent abdominal pain in adolescents with anxiety and depression disorders

    Fastralina Fastralina; Sri Sofyani; M. Joesoef Simbolon; Iskandar Z. Lubis

    2013-01-01

    Background Anxiety and depression disorders in adolescents may affect their academic performances and social functioning at school. Adolescents with these disorders sometimes develop recurrent abdominal pain (RAP). Objective To assess the occurence of recurrent abdominal pain among adolescents with anxiety and depression disorders Methods We conducted a cross-sectional study from August to September 2009 in 12-18 year-old adolescents from 3 junior high schools and 3 se...

  1. Recurrent abdominal pain in adolescents with anxiety and depression disorders

    Fastralina; Sri Sofyani; M. Joesoef Simbolon; Iskandar Z. Lubis

    2013-01-01

    Background Anxiety and depression disorders in adolescents may affect their academic performances and social functioning at school. Adolescents with these disorders sometimes develop recurrent abdominal pain (RAP). Objective To assess the occurence of recurrent abdominal pain among adolescents with anxiety and depression disorders Methods We conducted a cross-sectional study from August to September 2009 in 12–18 year-old adolescents from 3 junior high schools and 3 senior high school...

  2. Waist Circumference as Measure of Abdominal Fat Compartments

    Scott M. Grundy

    2013-01-01

    Full Text Available This study examines intercorrelations among waist circumference (WC, intraperitoneal fat (IPF, and subcutaneous abdominal fat (SAF in ethnically diverse Dallas Heart Study consisting of 1538 women and 1212 men (50% Black. Correlations between fat depots and triglyceride or HOMA2-IR, biomarkers of metabolic syndrome, are also reported. Total abdominal fat (TAF, ASF, and IPF masses were measured by magnetic resonance imaging. The highest correlations with WC according to ethnicity and gender were noted for TAF (R2=0.81-0.88 with progressively lower correlations with ASF (0.65–0.82 and IPF (0.29–0.85. The percentage of IPF relative to TAF was not significantly correlated with WC. For all WC categories, higher IPF/ASF ratios were associated with higher triglyceride levels. In contrast, differences in ratios had little or no association with HOMA2-IR. However, when all data were pooled, IPF was positively correlated with both triglyceride (r=0.358 (men and 0.363 (women and HOMA2-IR (r=0.480 (men and 0.517 (women; after adjustment for ASF, IPF was still correlated with triglyceride (r=0.353 (men and 0.348 (women and HOMA2-IR (r=0.290 (men and 0.221 (women. WC measures TAF reliably, but its association with IPF depends on IPF/ASF ratios that vary by gender and ethnicity.

  3. Intra-abdominal hypertension and abdominal compartment syndrome in association with ruptured abdominal aortic aneurysm in the endovascular era: vigilance remains critical.

    Bozeman, Matthew C; Ross, Charles B

    2012-01-01

    Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are common complications of ruptured abdominal aortoiliac aneurysms (rAAAs) and other abdominal vascular catastrophes even in the age of endovascular therapy. Morbidity and mortality due to systemic inflammatory response syndrome (SIRS) and multiple organ failure (MOF) are significant. Recognition and management of IAH are key critical care measures which may decrease morbidity and improve survival in these vascular patients. Two strategies have been utilized: expectant management with prompt decompressive laparotomy upon diagnosis of threshold levels of IAH versus prophylactic, delayed abdominal closure based upon clinical parameters at the time of initial repair. Competent management of the abdominal wound with preservation of abdominal domain is also an important component of the care of these patients. In this review, we describe published experience with IAH and ACS complicating abdominal vascular catastrophes, experience with ACS complicating endovascular repair of rAAAs, and techniques for management of the abdominal wound. Vigilance and appropriate management of IAH and ACS remains critically important in decreasing morbidity and optimizing survival following catastrophic intra-abdominal vascular events.

  4. Acute abdominal compartment syndrome complicating a colonoscopic perforation: a case report

    Souadka Amine

    2012-02-01

    Full Text Available Abstract Introduction A perforation occurring during colonoscopy is an extremely rare complication that may be difficult to diagnose. It can be responsible for acute abdominal compartment syndrome, a potentially lethal complex pathological state in which an acute increase in intra-abdominal pressure may provoke the failure of several organ systems. Case presentation We report a case of acute abdominal compartment syndrome after perforation of the bowel during a colonoscopy in a 60-year-old North African man with rectal cancer, resulting in respiratory distress, cyanosis and cardiac arrest. Our patient was treated by needle decompression after the failure of cardiopulmonary resuscitation. An emergency laparotomy with anterior resection, including the perforated sigmoid colon, was then performed followed by immediate anastomosis. Our patient remains alive and free of disease three years later. Conclusion Acute abdominal compartment syndrome is a rare disease that may occasionally occur after a colonoscopic perforation. It should be kept in mind during colonoscopy, especially considering its simple salvage treatment.

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

    Sugrue, Michael

    2012-01-31

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

  6. Abdominal intra-compartment syndrome - a non-hydraulic model of abdominal compartment syndrome due to post-hepatectomy hemorrhage in a man with a localized frozen abdomen due to extensive adhesions: a case report.

    Bressan, Alexsander K; Kirkpatrick, Andrew W; Ball, Chad G

    2016-09-15

    Postoperative hemorrhage is a significant cause of morbidity and mortality following liver resection. It typically presents early within the postoperative period, and conservative management is possible in the majority of cases. We present a case of late post-hepatectomy hemorrhage associated with overt abdominal compartment syndrome resulting from a localized functional compartment within the abdomen. A 68-year-old white man was readmitted with sudden onset of upper abdominal pain, vomiting, and hemodynamic instability 8 days after an uneventful hepatic resection for metachronous colon cancer metastasis. A frozen abdomen with adhesions due to complicated previous abdominal surgeries was encountered at the first intervention, but the surgery itself and initial recovery were otherwise unremarkable. Prompt response to fluid resuscitation at admission was followed by a computed tomography of his abdomen that revealed active arterial hemorrhage in the liver resection site and hemoperitoneum (estimated volume abdominal compartment syndrome. Surgical exploration confirmed a small volume of ascites and blood clots (1.2 L) under significant pressure in his supramesocolic region, restricted by his frozen lower abdomen, which we evacuated. Dramatic improvement in his ventilatory pressure was immediate. His abdomen was left open and a negative pressure device was placed for temporary abdominal closure. The fascia was formally closed after 48 hours. He was discharged home at postoperative day 6. Intra-abdominal pressure and radiologic findings of intra-abdominal hemorrhage should be carefully interpreted in patients with extensive intra-abdominal adhesions. A high index of suspicion and detailed understanding of abdominal compartment mechanics are paramount for the timely diagnosis of abdominal compartment syndrome in these patients. Clinicians should be aware that abnormal anatomy (such as adhesions) coupled with localized pathophysiology (such as hemorrhage) can create a so

  7. Recurrent severe abdominal pain in the pediatric patient.

    Homme, James L; Foster, Ashley A

    2014-05-01

    Ureteropelvic junction obstruction (UPJO) is a blockage occurring at the junction of the ureter and the renal pelvis. Pediatric patients with UPJO pose a diagnostic challenge when they present to the emergency department (ED) with severe recurrent abdominal pain if there is not a level of suspicion for this condition. Our aim was to review presentation of UPJO to the ED, methods of diagnosis, and treatment of this common but often overlooked condition. We report on 2 patients, a 9-year-old and 3-year-old, who had multiple presentations to health care providers and the ED with intermittent and recurrent abdominal pain. Subsequent testing, including ultrasound (US) and computed tomography (CT) with diuretic-recreated symptoms, revealed UPJO. Open pyeloplasty was performed, resulting in complete resolution of symptoms. UPJO is an important diagnosis to consider when patients present to the ED with recurrent abdominal pain. US can be helpful in suspecting the diagnosis, but often CT, magnetic resonance urography, or diuretic scintigraphy is required for confirmation. Diuretics can be used to aid diagnostic testing by reproducing abdominal pain at the time of imaging. Referral to a urologist for open pyeloplasty is definitive treatment for this condition. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Hypertonic lactated saline resuscitation reduces the risk of abdominal compartment syndrome in severely burned patients.

    Oda, Jun; Ueyama, Masashi; Yamashita, Katsuyuki; Inoue, Takuya; Noborio, Mitsuhiro; Ode, Yasumasa; Aoki, Yoshiki; Sugimoto, Hisashi

    2006-01-01

    Secondary abdominal compartment syndrome is a lethal complication after resuscitation from burn shock. Hypertonic lactated saline (HLS) infusion reduces early fluid requirements in burn shock, but the effects of HLS on intraabdominal pressure have not been clarified. Patients admitted to our burn unit between 2002 and 2004 with burns > or =40% of the total body surface area without severe inhalation injury were entered into a fluid resuscitation protocol using HLS (n = 14) or lactated Ringer's solution (n = 22). Urine output was monitored hourly with a goal of 0.5 to 1.0 mL/kg per hour. Hemodynamic parameters, blood gas analysis, intrabladder pressure as an indicator of intraabdominal pressure (IAP), and the peak inspiratory pressure were recorded. Pulmonary compliance and the abdominal perfusion pressure were also calculated. In the HLS group, the amount of intravenous fluid volume needed to maintain adequate urine output was less at 3.1 +/- 0.9 versus 5.2 +/- 1.2 mL/24 h per kg per percentage of total body surface area, and the peak IAP and peak inspiratory pressure at 24 hours after injury were significantly lower than those in the lactated Ringer's group. Two of 14 patients (14%) in the HLS group and 11 of 22 patients (50%) developed IAH within 20.8 +/- 7.2 hours after injury. In patients with severe burn injury, a large intravenous fluid volume decreases abdominal perfusion during the resuscitative period because of increased IAP. Our data suggest that HLS resuscitation could reduce the risk of secondary abdominal compartment syndrome with lower fluid load in burn shock patients.

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

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

    2015-01-01

    Abdominal compartment syndrome (ACS) is defined as an increase of intra-abdominal pressure (IAH) to values higher than 20 mmHg, associated with reduced perfusion and organ dysfunction. There is a classification of open abdomen which stratifies patients according to the natural history of improvement or clinical deterioration. The aim of treatment is to maintain the open abdomen at the lowest level and to prevent progression to a more complex level. Surgical treatment essentially consists in abdominal decompression by leaving the abdomen open. Analysis of the literature shows that negative pressure increases the rate of primary fascial closure; entero-cutaneous fistulas are seen in a minority of cases, without seeming consequence of the application of the dressing. Open abdomen management consists of three treatment stages: acute (24-48 hours), intermediate (from 48 hours to 10 days) and late or reconstruction (from 10 days to the final closure). It's important to recognize patients at risk of IAH and the first signs of ACS and intervene early with abdominal decompression if this will establish itself. Management of the open abdomen is now facilitated by negative pressure devices, which positively affect the morbidity and mortality of patients with ACS.

  10. COMPARTMENTS

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

    2014-01-01

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

  11. [Two compartment model of body composition and abdominal fat area in postmenopausal women - pilot study].

    Milewska, Magdalena; Mioduszewska, Milena; Pańczyk, Mariusz; Kucharska, Alicja; Sińska, Beata; Dąbrowska-Bender, Marta; Michota-Katulska, Ewa; Zegan, Magdalena; Szabla, Anna

    2016-01-01

    Both menopausal period and aging have influence on body composition, increase of total body fat and visceral fat in particular. We should be aware that changes in body composition, mainly fat translocation to abdominal region, can occur without significant changes in body weight. Therefore quantitative abdominal fat assessment should be our aim. Body composition analysis based on two compartment model and abdominal fat area assessment in cross section. Subjects in postmenopausal period (41 women) were recruited for this study and divided into 2 groups: group 1 - women aged 45-56 years and group 2 - women aged 57-79 years. Body composition analysis and abdominal fat area assessment were conducted by using bioelectrical impedance method with BioScan 920 (Maltron int.) accordingly with standardized procedure. Women in early postmenopausal stage (Group 1) had statistically significant lower total body fat percentage in comparison with women in late postmenopausal period (Group 2) (41.09 ± 7.72% vs. 50.7 ± 9.88%, p=0.0021). Also women in group 1 were characterized by significant lower visceral fat area (VAT) as well as subcutaneous fat area (SAT) in comparison with group 2 (respectively VAT 119.25 ± 30.09 cm2 vs. 199.36 ± 87.38 cm2, p=0.0011; SAT 175.19 ±57.67 cm2 vs. 223.4±74.29 cm2, p=0.0336). According to VAT criteria (>120 cm2), 44% of women in group 1 and 80% in group 2 had excess of visceral fat. Both total body fat and intra-abdominal fat increased with age, independently of weight changes.

  12. Helicobacter pylori gastritis in a child with sickle cell anemia and recurrent abdominal pain.

    Kennedy, L; Mahoney, D H; Redel, C A

    1997-01-01

    Recurrent abdominal pain is a common complaint in children with sickle cell disease. Helicobacter pylori gastritis has recently been described in association with recurrent abdominal pain in children. A case report is given of a 16-year-old black male with hemoglobin SS disease presenting with recurrent abdominal pain and hematemesis. Endoscopic exam of the upper gastrointestinal tract revealed gastritis, and biopsy confirmed H. pylori infection. Serology studies demonstrated increased anti-H. pylori antibody titers. The young man responded well to treatment, with resolution of his symptoms. Helicobacter pylori infection is a new diagnostic consideration for children with recurrent abdominal pain and should be included in the differential diagnosis of children with sickle cell disease, especially when abdominal pain is recurrent and accompanied by vomiting. Larger case studies will be necessary to determine the true incidence of H. pylori in children with sickle cell disease and recurrent abdominal pain.

  13. Recurrence of Pelvic Chondrosarcoma through Fascial Defect into Abdominal Cavity

    Kemal Gökkuş

    2014-01-01

    Full Text Available Our patient was a 76-year-old female who has been operated on 2 times in 8 years for pelvic chondrosarcoma. The patient came to our clinic with a large mass in left iliac region which extended into the paravertebral area. Physical examination and preoperative imagining studies revealed a mass at the left iliac area that infiltrated sciatic notch and extended from posterior iliac region towards the anterior side of iliac bone through the sciatic notch and an incisional hernia including descending colon. The mass was also penetrating the abdominal cavity through the hernia. Surgical intervention was planned. Since the tumor infiltrated the sciatic nerve, hemipelvectomy was indicated. Patient refused hemipelvectomy. Therefore, palliative debulking surgery was considered. We treated the case with marginal excision and abdominal wall reconstruction employing prolene and vicryl suture materials in order to prevent a postoperative visceral herniation and local invasion. At the latest follow-up appointment in 2 years, the patient still had no signs of tumor recurrence. This case showed us that an incisional hernia can serve as a pathway for the recurrence invasion of the chondrosarcoma.

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

    Dejan V. Radenkovic

    2016-01-01

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

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

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

    2016-01-01

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

  16. Protozoa as a cause of recurrent abdominal pain in children.

    Gijsbers, Carolien F M; Schweizer, Joachim J; Büller, Hans A

    2013-11-01

    The aim of this study was to investigate whether protozoa can be identified as a cause of recurrent abdominal pain (RAP), and whether protozoan infections can be recognized by a specific clinical presentation. For 2 years, all patients (ages 4-16 years) fulfilling the Apley criteria of RAP referred to secondary care were prospectively evaluated for protozoa (Giardia lamblia, Dientamoeba fragilis, Blastocystis hominis) and treated if positive. Re-examination followed at least 10 days after treatment. Disappearance of pain with eradication and a pain-free follow-up of at least 6 months were considered to be indicative of a causal relation with RAP. The predictive value of the characteristics of the pain for protozoan infections was calculated. Of 220 included patients (92 boys, mean age 8.8 years), 215 brought a stool sample; 73 (34%) carried parasites, 10 of whom had 2 parasites, 2 had 3 parasites. Sixty-five patients were treated. Twenty-five (11%) were pain-free after eradication (21 had D fragilis, 8 B hominis, 4 G lamblia), of whom 11 had another infection (2) or constipation (9) as second diagnosis for the pain. Five had recurrence of infection with D fragilis and were again pain-free with eradication. Patients with protozoa as cause of their pain did not show differences with respect to their presentation when compared with patients with an asymptomatic infection and patients without protozoa. Protozoa were found as the cause of pain in 6% to 11% of children with RAP. These patients did not show a characteristic presentation when compared with patients with other causes of abdominal pain.

  17. Citalopram Treatment of Pediatric Recurrent Abdominal Pain and Comorbid Internalizing Disorders: An Exploratory Study

    Campo, John V.; Perel, James; Lucas, Amanda; Bridge, Jeff; Ehmann, Mary; Kalas, Catherine; Monk, Kelly; Axelson, David; Birmaher, Boris; Ryan, Neal; Di Lorenzo, Carlo; Brent, David A.

    2004-01-01

    Objective: To assess the potential efficacy, tolerability, and safety of citalopram in the treatment of functional pediatric recurrent abdominal pain and comorbid internalizing disorders. Method: Twenty-five clinically referred children and adolescents with recurrent abdominal pain aged 7 to 18 years, inclusive, participated in a 12-week,…

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

    Aisha W Shaheen

    2016-01-01

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

  19. The subcutaneous abdominal fat and not the intraabdominal fat compartment is associated with anovulation in women with obesity and infertility.

    Kuchenbecker, Walter K H; Groen, Henk; Zijlstra, Tineke M; Bolster, Johanna H T; Slart, Riemer H J; van der Jagt, Erik J; Kobold, Anneke C Muller; Wolffenbuttel, Bruce H R; Land, Jolande A; Hoek, Annemieke

    2010-05-01

    Abdominal fat contributes to anovulation. We compared body fat distribution measurements and their contribution to anovulation in obese ovulatory and anovulatory infertile women. Seventeen ovulatory and 40 anovulatory women (age, 30 +/- 4 yr; body mass index, 37.7 +/- 6.1 kg/m(2)) participated. Body fat distribution was measured by anthropometrics, dual-energy x-ray absorptiometry, and single-sliced abdominal computed tomography scan. Multiple logistic regression analysis was applied to determine which fat compartments significantly contributed to anovulation. Anovulatory women had a higher waist circumference (113 +/- 11 vs. 104 +/- 9 cm; P fat (23.0 +/- 5.3 vs. 19.1 +/- 4.2 kg; P abdominal fat (4.4 +/- 1.3 kg vs. 3.5 +/- 0.9 kg; P fat on single-sliced abdominal computed tomography scan was not significantly different between the two groups (203 +/- 56 vs. 195 +/- 71 cm(3); P = 0.65), but anovulatory women had significantly more sc abdominal fat (SAF) (992 +/- 198 vs. 864 +/- 146 cm(3); P fat, abdominal fat, and SAF were associated with anovulation. Abdominal fat is increased in anovulatory women due to a significant increase in SAF and not in intraabdominal fat. SAF and especially abdominal and trunk fat accumulation are associated with anovulation.

  20. A pilot study examining experiential learning vs didactic education of abdominal compartment syndrome.

    Saraswat, Anju; Bach, John; Watson, William D; Elliott, John O; Dominguez, Edward P

    2017-08-01

    Current surgical education relies on simulated educational experiences or didactic sessions to teach low-frequency clinical events such as abdominal compartment syndrome (ACS). The purpose of this pilot study was to evaluate if simulation would improve performance and knowledge retention of ACS better than a didactic lecture. Nineteen general surgery residents were block randomized by postgraduate year level to a didactic or a simulation session. After 3 months, all residents completed a knowledge assessment before participating in an additional simulation. Two independent reviewers assessed resident performance via audio-video recordings. No baseline differences in ACS experience were noted between groups. The observational evaluation demonstrated a significant difference in performance between the didactic and simulation groups: 9.9 vs 12.5, P = .037 (effect size = 1.15). Knowledge retention was equivalent between groups. This pilot study suggests that simulation-based education may be more effective for teaching the basic concepts of ACS. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. One elevated bladder pressure measurement may not be enough to diagnose abdominal compartment syndrome.

    Young, Andrew Joseph; Weber, William; Wolfe, Luke; Ivatury, Rao R; Duane, Therese Marie

    2013-02-01

    Bladder pressure measurements (BPMs) are considered a key component in the diagnosis of abdominal compartment syndrome (ACS). The purpose of this observational review was to determine risk factors of ACS and associated mortality with particular focus on the role of BPM. A retrospective trauma registry and chart review was performed on trauma patients from January 2003 through December 2010. Comparisons were made between patients with and without ACS. There were 3172 patients included in the study of whom 46 had ACS. Patients with ACS were younger, more severely injured, with longer lengths of stay. Logistic regression determined Injury Severity Score (ISS) and urinary catheter days as independent predictors of ACS, whereas independent predictors of mortality included age, ISS, and ACS. Subset analysis demonstrated no association between BPM 20 mmHg or greater and diagnosis of ACS versus no ACS. Logistic regression indicated independent predictors of mortality were number of BPM 20 mmHg or greater and age. Patients with ACS are more severely injured with worse outcomes. An isolated BPM 20 mmHg or greater was not associated with ACS and may be inadequate to independently diagnose ACS. These findings suggest the need for repeat measurements with early intervention if they remain elevated in an effort to decrease mortality associated with ACS.

  2. The prevalence and related symptomatology of Helicobacter pylori in children with recurrent abdominal pain

    Wewer, Anne Vibeke; Andersen, L P; Pærregaard, Anders

    1998-01-01

    The aim of the study was to assess and compare the IgG seroprevalence of H. pylori in children with recurrent abdominal pain with healthy children and to investigate the related symptoms. IgG antibodies against low-molecular weight H. pylori antigens were assessed in 438 children with recurrent...... abdominal pain and in 91 healthy controls. Sera with an ELISA unit-value above the cut-off level were confirmed by Western immunoblot. Only seropositive children with recurrent abdominal pain were examined by an oesophago-gastro-duodenoscopy. Symptomatology was recorded according to the localization...... of the abdominal pain, presence of pyrosis, nocturnal pain, relation of pain to meals and bowel irregularities. The seroprevalence was 21% (95% CI: 17-25%) in the children with recurrent abdominal pain and 10% (95% CI: 5-18%) in the healthy controls (p = 0.30). In seropositive children with RAP H. pylori was found...

  3. Small bowel permeability to 51Cr-EDTA in children with recurrent abdominal pain

    Meer, S.B. van der.; Forget, P.P.

    1990-01-01

    Small bowel permeability was investigated in 87 children with recurrent abdominal pain by measuring the 24-h urinary excretion of orally administered 51 Cr-EDTA. The mean excreation was 3.64% ± 1.49% per 24 h. The difference between the mean urinary excretion in children with recurrent abdominal pain and control children (2.51% ± 0.70%), was significant (p<0.01, two sample t-test). The increased small permeability in children with recurrent abdominal pain might indicate an intestinal etiology for the patients complaints

  4. Abdominal wall perforation in a patient with recurrent epithelial ovarian cancer after bevacizumab treatment

    Efnan Algin

    2016-08-01

    Full Text Available Bowel perforation is a rare but well-described complication of bevacizumab, a VEGF monoclonal antibody. However, bevacizumab associated abdominal wall perforation is a more serious complication. In here, a patient with recurrent epithelial ovarian cancer developing both bowel and abdominal wall perforation after bevacizumab treatment is reported with review of the literature to point out the clinical significance of this rare complication. To our knowledge, this is the first case with bevacizumab associated abdominal wall perforation.

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

    Matthew C. Bozeman

    2012-01-01

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

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

    Noel, P.B.; Bauer, J.S.; Ganter, C.; Markus, C.; Rummeny, E.J.; Engels, H.P.; Hauner, H.

    2012-01-01

    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.)

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

    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.)

  8. Abdominal adipose tissue compartments vary with ethnicity in Asian neonates: Growing Up in Singapore Toward Healthy Outcomes birth cohort study.

    Tint, Mya Thway; Fortier, Marielle V; Godfrey, Keith M; Shuter, Borys; Kapur, Jeevesh; Rajadurai, Victor S; Agarwal, Pratibha; Chinnadurai, Amutha; Niduvaje, Krishnamoorthy; Chan, Yiong-Huak; Aris, Izzuddin Bin Mohd; Soh, Shu-E; Yap, Fabian; Saw, Seang-Mei; Kramer, Michael S; Gluckman, Peter D; Chong, Yap-Seng; Lee, Yung-Seng

    2016-05-01

    A susceptibility to metabolic diseases is associated with abdominal adipose tissue distribution and varies between ethnic groups. The distribution of abdominal adipose tissue at birth may give insights into whether ethnicity-associated variations in metabolic risk originate partly in utero. We assessed the influence of ethnicity on abdominal adipose tissue compartments in Asian neonates in the Growing Up in Singapore Toward Healthy Outcomes mother-offspring cohort. MRI was performed at ≤2 wk after birth in 333 neonates born at ≥34 wk of gestation and with birth weights ≥2000 g. Abdominal superficial subcutaneous tissue (sSAT), deep subcutaneous tissue (dSAT), and internal adipose tissue (IAT) compartment volumes (absolute and as a percentage of the total abdominal volume) were quantified. In multivariate analyses that were controlled for sex, age, and parity, the absolute and percentage of dSAT and the percentage of sSAT (but not absolute sSAT) were greater, whereas absolute IAT (but not the percentage of IAT) was lower, in Indian neonates than in Chinese neonates. Compared with Chinese neonates, Malay neonates had greater percentages of sSAT and dSAT but similar percentages of IAT. Marginal structural model analyses largely confirmed the results on the basis of volume percentages with controlled direct effects of ethnicity on abdominal adipose tissue; dSAT was significantly greater (1.45 mL; 95% CI: 0.49, 2.41 mL, P = 0.003) in non-Chinese (Indian or Malay) neonates than in Chinese neonates. However, ethnic differences in sSAT and IAT were NS [3.06 mL (95% CI:-0.27, 6.39 mL; P = 0.0712) for sSAT and -1.30 mL (95% CI: -2.64, 0.04 mL; P = 0.057) for IAT in non-Chinese compared with Chinese neonates, respectively]. Indian and Malay neonates have a greater dSAT volume than do Chinese neonates. This finding supports the notion that in utero influences may contribute to higher cardiometabolic risk observed in Indian and Malay persons in our population. If such

  9. Navigating recurrent abdominal pain through clinical clues, red flags, and initial testing.

    Noe, Joshua D; Li, B U K

    2009-05-01

    Recurrent abdominal pain is a common chronic complaint that presents to your office. The constant challenge is one of detecting those with organic disease from the majority who have a functional pain disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical exam, you can: 1) apply the symptom-based Rome III criteria to positively identify a functional disorder, and 2) filter these findings through the diagnostic clues and red flags that point toward specific organic disease and/or further testing. Once a functional diagnosis has been made or an organic disease is suspected, you can initiate a self-limited empiric therapeutic trial. With this diagnostic approach, you should feel confident navigating through the initial evaluation, management, and consultation referral for a child or adolescent with recurrent abdominal pain.

  10. The prevalence and related symptomatology of Helicobacter pylori in children with recurrent abdominal pain

    Wewer, Anne Vibeke; Andersen, L P; Pærregaard, Anders

    1998-01-01

    in 46/66 by culture and histology. The presence of H. pylori was significantly associated with active or inactive chronic gastritis. The presence of H. pylori was associated with both parents being born in a country with a high prevalence and a low social class. Helicobacter pylori-positive children had......The aim of the study was to assess and compare the IgG seroprevalence of H. pylori in children with recurrent abdominal pain with healthy children and to investigate the related symptoms. IgG antibodies against low-molecular weight H. pylori antigens were assessed in 438 children with recurrent...... of the abdominal pain, presence of pyrosis, nocturnal pain, relation of pain to meals and bowel irregularities. The seroprevalence was 21% (95% CI: 17-25%) in the children with recurrent abdominal pain and 10% (95% CI: 5-18%) in the healthy controls (p = 0.30). In seropositive children with RAP H. pylori was found...

  11. Psychological aspects of Recurrent Abdominal Pain Syndrome in children.

    Moayedi, A; Moayedi, F

    2015-01-01

    Introduction. Intermittent visceral distress syndrome is described as "at least three scenes of visceral distress, sufficiently severe to hinder their actions over a time longer than 3 months, continuing from the preceding year". Organic factors causing abdominal pain are rare, so most of the children with an intermittent visceral distress are designated to have a functional abdominal pain. This study was designed to evaluate psychological problems such as anxiety and distress in children with functional intestinal distress. Method. 120 children (50 boys and 70 girls) with an age range of 5-18 years, who complained of abdominal pain among other things, were included in this cross-sectional case-control study (forty with an organic etiology, 38 diagnosed as RAPS and 42 healthy controls). Revised Children's Manifest Anxiety Scale (RCMAS) questionnaire and Depression Self-Rated Scale (DSRS) questionnaire were used to determine the level of anxiety. A 28-question General Health Questionnaire (GHQ-28) was also used to investigate the general mental health of their mothers. Result. In the present study, organic and functional etiology of abdominal pain was significantly different with regard to the anxiety score. However, this was not seen as far as depression was concerned. The total GHQ score of mothers was not significantly different between the three groups. ANOVA was used to compare groups. Conclusion. As shown in the present study, that is consistent with most other studies, psychological factors were seen in RAP and need a more in depth investigation to be resolved.

  12. Dietary interventions for recurrent abdominal pain in childhood.

    Newlove-Delgado, Tamsin V; Martin, Alice E; Abbott, Rebecca A; Bethel, Alison; Thompson-Coon, Joanna; Whear, Rebecca; Logan, Stuart

    2017-03-23

    This is an update of the original Cochrane review, last published in 2009 (Huertas-Ceballos 2009). Recurrent abdominal pain (RAP), including children with irritable bowel syndrome, is a common problem affecting between 4% and 25% of school-aged children. For the majority of such children, no organic cause for their pain can be found on physical examination or investigation. Many dietary inventions have been suggested to improve the symptoms of RAP. These may involve either excluding ingredients from the diet or adding supplements such as fibre or probiotics. To examine the effectiveness of dietary interventions in improving pain in children of school age with RAP. We searched CENTRAL, Ovid MEDLINE, Embase, eight other databases, and two trials registers, together with reference checking, citation searching and contact with study authors, in June 2016. Randomised controlled trials (RCTs) comparing dietary interventions with placebo or no treatment in children aged five to 18 years with RAP or an abdominal pain-related, functional gastrointestinal disorder, as defined by the Rome III criteria (Rasquin 2006). We used standard methodological procedures expected by Cochrane. We grouped dietary interventions together by category for analysis. We contacted study authors to ask for missing information and clarification, when needed. We assessed the quality of the evidence for each outcome using the GRADE approach. We included 19 RCTs, reported in 27 papers with a total of 1453 participants. Fifteen of these studies were not included in the previous review. All 19 RCTs had follow-up ranging from one to five months. Participants were aged between four and 18 years from eight different countries and were recruited largely from paediatric gastroenterology clinics. The mean age at recruitment ranged from 6.3 years to 13.1 years. Girls outnumbered boys in most trials. Fourteen trials recruited children with a diagnosis under the broad umbrella of RAP or functional

  13. Gastric Dilatation and Abdominal Compartment Syndrome in a Child with Prader-Willi Syndrome.

    Blat, Clara; Busquets, Elisenda; Gili, Teresa; Caixàs, Assumpta; Gabau, Elisabeth; Corripio, Raquel

    2017-06-07

    BACKGROUND Prader-Willi syndrome (PWS) is a genetic disorder characterized by initial muscular hypotonia and feeding difficulties, and later an insatiable appetite, hyperphagia and obesity along with mild to moderate intellectual impairment. Affected individuals' food-seeking behavior and suspected delayed gastric emptying can lead to gastric dilatation with subsequent necrosis and perforation. CASE REPORT We present the case of a 5-year-old boy diagnosed with Prader-Willi syndrome at neonatal age due to muscular hypotonia, who started growth hormone therapy at 20 months. He presented with two episodes of a rapidly progressing gastric dilatation that led to abdominal hypertension and secondary shock at the age of 2 and 5. No large amount of food was eaten before any of the episodes, and he had abdominal pain and vomiting on both occasions. On arrival at the emergency room, a nasogastric tube was placed and aspiration of food material was performed. Abdominal X-ray and CT scan revealed massive gastric dilatation. He was admitted at the Pediatric Intensive Care Unit and after a variable period of fasting, tolerated oral intake and could be discharged. CONCLUSIONS Gastric dilatation due to gastroparesis in PWS is a rare complication. However, it is a life-threatening situation and physicians should therefore maintain a high level of suspicion for gastric dilatation when patients present with warning symptoms such as abdominal pain or discomfort and vomiting.

  14. Clinical and laboratory findings in 220 children with recurrent abdominal pain

    Gijsbers, C. F. M.; Benninga, M. A.; Büller, H. A.

    2011-01-01

    Aim: To investigate the clinical and laboratory findings in children with recurrent abdominal pain (RAP). Methods: Consecutive patients with RAP (Apley criteria), age 4-16 years, referred to a secondary medical centre were evaluated by a standardized history, physical examination and laboratory

  15. Isolated abdominal wound recurrence of an endometrial adenocarcinoma confined to a polyp

    Barter, J.F.; Hatch, K.D.; Orr, J.W. Jr.; Shingleton, H.M.

    1986-01-01

    An unusual case of Stage IB moderately well-differentiated endometrial adenocarcinoma that was confined to a polyp and recurred only in the abdominal wound is presented. Eighteen months following complete excision, local electron beam therapy, and the institution of hormonal therapy, the patient is alive and without other evidence of recurrence. The mechanisms of metastasis in this case are discussed

  16. Efficacy of a Brief Relaxation Training Intervention for Pediatric Recurrent Abdominal Pain

    Bell, Katrina M.; Meadows, Elizabeth A.

    2013-01-01

    This study is a preliminary investigation of the efficacy of a brief intervention for recurrent abdominal pain (RAP) via a multiple baseline across subjects design. The intervention consisted of a single 1-hour session including psychoeducation and coaching of breathing retraining; the length, duration, and content of the intervention were…

  17. Recurrence rates after abdominal and vaginal cerclages in women with cervical insufficiency

    Sneider, Kirstine; Christiansen, Ole Bjarne; Sundtoft, Iben Blaabjerg

    2017-01-01

    PURPOSE: To estimate the incidence of cervical insufficiency and compare recurrence rates of second trimester miscarriage/delivery in second and third pregnancies after prophylactic vaginal cerclage, abdominal cerclage, or no cerclage. METHODS: Retrospective chart review of a representative...... register-based sample of 621 women with a spontaneous second trimester miscarriage/delivery in the first pregnancy in Denmark (1997-2012). We used strict criteria for the diagnosis of cervical insufficiency. The outcome of subsequent pregnancies was described by treatment with prophylactic vaginal cerclage......, abdominal cerclage, or no prophylactic cerclage. Women were followed until June 2015. RESULTS: Of 621 women, 149 (24%) fulfilled the strict criteria of cervical insufficiency. Prophylactic treatment with abdominal cerclage (n = 20), vaginal cerclage (n = 59), and no prophylactic cerclage (n = 61) resulted...

  18. The Decrease of Peripheral Blood CD4+ T Cells Indicates Abdominal Compartment Syndrome in Severe Acute Pancreatitis.

    Yao Liu

    Full Text Available Few data are available on the role of T lymphocytes and inflammatory cytokines in abdominal compartment syndrome (ACS in severe acute pancreatitis (SAP. We conducted a retrospective study to assess the risk factors associated with ACS in SAP.A total of 76 SAP patients who were admitted within 24 hours after symptom onset in our study. There were 36 patients suffering from ACS and 40 from intra-abdominal hypertension (IAH. On the 1st, 3rd and 7th days after hospital admission, the following variables were assessed: serum value of C-reactive protein (CRP, and the proportions of peripheral CD4+ and CD8+ T lymphocytes. Acute Physiology and Chronic Health Evaluation II (APACHE II score, and computed tomography severity index (CTSI score were assessed on days 1 and 7 after hospitalization.Compared with the patients with IAH, ACS patients showed statistically higher CRP value on 7th day after hospital admission, proportions of CD4+ T cells on days 1, 3, 7 and CD4+/CD8+ ratio on day 1 were significantly lower (P < 0.05, respectively. A CD4+ T cell proportion of 30.3% on the 1st day indicated ACS with an area under the curve (AUC of 0.774, a sensitivity with 82.5% and specificity with 72.0%, respectively. Sensitivity/specificity for predicting ACS in SAP patients on day 1 was 70.0%/68.0% for CD4+/CD8+ ratio, 72.2%/65.0% for APACHE II score.The reduction of peripheral blood CD4+ T lymphocytes is associated with ACS in SAP, and may act as a potential predictor of ACS in SAP.

  19. Automatic segmentation of abdominal organs and adipose tissue compartments in water-fat MRI: Application to weight-loss in obesity.

    Shen, Jun; Baum, Thomas; Cordes, Christian; Ott, Beate; Skurk, Thomas; Kooijman, Hendrik; Rummeny, Ernst J; Hauner, Hans; Menze, Bjoern H; Karampinos, Dimitrios C

    2016-09-01

    To develop a fully automatic algorithm for abdominal organs and adipose tissue compartments segmentation and to assess organ and adipose tissue volume changes in longitudinal water-fat magnetic resonance imaging (MRI) data. Axial two-point Dixon images were acquired in 20 obese women (age range 24-65, BMI 34.9±3.8kg/m(2)) before and after a four-week calorie restriction. Abdominal organs, subcutaneous adipose tissue (SAT) compartments (abdominal, anterior, posterior), SAT regions along the feet-head direction and regional visceral adipose tissue (VAT) were assessed by a fully automatic algorithm using morphological operations and a multi-atlas-based segmentation method. The accuracy of organ segmentation represented by Dice coefficients ranged from 0.672±0.155 for the pancreas to 0.943±0.023 for the liver. Abdominal SAT changes were significantly greater in the posterior than the anterior SAT compartment (-11.4%±5.1% versus -9.5%±6.3%, pabdominal adipose tissue and organ segmentation, and allowed the detection of SAT and VAT subcompartments changes during weight loss. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Validation of the Rome III criteria and alarm symptoms for recurrent abdominal pain in children.

    Gijsbers, Carolien F M; Benninga, Marc A; Schweizer, Joachim J; Kneepkens, C M Frank; Vergouwe, Yvonne; Büller, Hans A

    2014-06-01

    Rome criteria were formulated to define functional gastrointestinal disorders (Rome III criteria, 2006) excluding organic diagnoses when alarm symptoms were absent. The aims of the study were to validate the Rome III criteria as to their capacity to differentiate between organic and functional abdominal pain and to assess the role of alarm symptoms in this differentiation. During 2 years all of the patients (ages 4-16 years) presenting with recurrent abdominal pain (Apley criteria) and referred to secondary care were included. Clinical diagnoses were based on protocolized evaluation and intervention with 6-month follow-up. Alarm symptoms were registered. Rome III criteria for functional pain syndromes were assigned independently. Descriptive statistical analyses were performed. In 200 patients (87 boys, mean age 8.8 years), organic (17%), functional (40%), combined organic and functional (9%), spontaneous recovery (27%), and other (8%) clinical diagnoses were established. Alarm symptoms were found in 57.5% (organic causes 56%, functional causes 61%). The evaluation for Rome symptom clusters revealed symptoms of irritable bowel syndrome in 27%, functional dyspepsia in 15%, functional abdominal pain in 28%, functional abdominal pain syndrome in 14.5%, and no pain syndrome in 15.5%. Rome diagnoses, based on symptoms and absence of alarm symptoms, predicted functional clinical diagnosis with sensitivity 0.35 (95% confidence interval 0.27-0.43), specificity 0.60 (0.46-0.73), positive predictive value 0.71 (0.61-0.82), and negative predictive value of 0.24 (0.17-0.32). The Rome III criteria for abdominal pain are not specific enough to rule out organic causes. Alarm symptoms do not differentiate between organic and functional abdominal pain.

  1. Enteral Nutrition Support for Abdominal Compartment Syndrome in Morbidly Obese Patient : A Case Report from a Medical Intensive Care Unit (ICU

    Nurul Huda Razalli

    2018-01-01

    Full Text Available Compartment syndrome occurs when pressure within a closed muscle or bone compartment builds to dangerous levels. This pressure can decrease blood flow to nerve and muscle cells, leading to ischemia and organ dysfunction. Challenges in providing enteral nutrition for abdominal compartment syndrome (ACS patients include the increase risk for developing gastrointestinal symptoms such as diarrhea, constipation and distention. There are limited reports available on the nutritional management of ACS patients in the ICU especially those with morbid obesity condition to guide dietitians in providing nutritional support for these patients.  Here, we report the enteral nutrition management of a mechanically ventilated, morbidly obese patient with ACS in a critical care setting by adopting postpyloric feeding, using prokinetic agents and implementing PO2/FiO2 ratio calculation for prescription of most suitable enteral formula.

  2. Correct the Coagulopathy and Scoop It Out: Complete Reversal of Anuric Renal Failure through the Operative Decompression of Extraperitoneal Hematoma-Induced Abdominal Compartment Syndrome

    Paul B. McBeth

    2012-01-01

    Full Text Available We report two cases of extraperitoneal compression of the intra-abdominal space resulting in abdominal compartment syndrome (ACS with overt renal failure, which responded to operative decompression of the extra-peritoneal spaces. This discussion includes patient presentation, clinical course, diagnosis, interventions, and outcomes. Data was collected from the patient’s electronic medical record and a radiology database. ACS appears to be a rare but completely reversible complication of both retroperitoneal hematoma (RH and rectus sheath hematoma (RSH. In patients with large RH or RSH consideration of intra-abdominal pressure (IAP monitoring combined with aggressive operative drainage after correction of the coagulopathy should be considered. These two cases illustrate how a relatively benign pathology can result in increased IAP, organ failure, and ultimately ACS. Intervention with decompressive laparotomy and evacuation of clot resulted in return to normal physiologic function.

  3. Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial

    Shapiro Daniel E

    2006-11-01

    Full Text Available Abstract Background Because of the paucity of effective evidence-based therapies for children with recurrent abdominal pain, we evaluated the therapeutic effect of guided imagery, a well-studied self-regulation technique. Methods 22 children, aged 5 – 18 years, were randomized to learn either breathing exercises alone or guided imagery with progressive muscle relaxation. Both groups had 4-weekly sessions with a therapist. Children reported the numbers of days with pain, the pain intensity, and missed activities due to abdominal pain using a daily pain diary collected at baseline and during the intervention. Monthly phone calls to the children reported the number of days with pain and the number of days of missed activities experienced during the month of and month following the intervention. Children with ≤ 4 days of pain/month and no missed activities due to pain were defined as being healed. Depression, anxiety, and somatization were measured in both children and parents at baseline. Results At baseline the children who received guided imagery had more days of pain during the preceding month (23 vs. 14 days, P = 0.04. There were no differences in the intensity of painful episodes or any baseline psychological factors between the two groups. Children who learned guided imagery with progressive muscle relaxation had significantly greater decrease in the number of days with pain than those learning breathing exercises alone after one (67% vs. 21%, P = 0.05, and two (82% vs. 45%, P Conclusion The therapeutic efficacy of guided imagery with progressive muscle relaxation found in this study is consistent with our present understanding of the pathophysiology of recurrent abdominal pain in children. Although unfamiliar to many pediatricians, guided imagery is a simple, noninvasive therapy with potential benefit for treating children with RAP.

  4. Deficiency in memory B cell compartment in a patient with infertility and recurrent pregnancy losses.

    Sung, N; Byeon, H J; Garcia, M D Salazar; Skariah, A; Wu, L; Dambaeva, S; Beaman, K; Gilman-Sachs, A; Kwak-Kim, J

    2016-11-01

    Alterations in normal balance of B cell subsets have been reported in various rheumatic diseases. In this study, we report a woman with a history of recurrent pregnancy losses (RPL) and infertility who had low levels of memory B cells. A 35-year-old woman with a history of RPL and infertility was demonstrated to have increased peripheral blood CD19+ B cells with persistently low levels of memory B cell subsets. Prior to the frozen donor egg transfer cycle, prednisone and intravenous immunoglobulin G (IVIg) treatment was initiated and patient achieved dichorionic diamniotic twin pregnancies. During pregnancy, proportion (%) of switched memory B cells CD27+IgD- increased, while percent of total CD19+ B cells and CD27-IgD+ naive B cells were gradually decreased with a high dose IVIg treatment. She developed cervical incompetence at 20 weeks of gestation, received a Cesarean section at 32 weeks of gestation due to preterm labor, and delivered twin babies. B cell subset abnormalities may be associated with infertility, RPL and preterm labor, and further investigation is needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. The prevalence of recurrent abdominal pain in 11- to 16-year-old Malaysian schoolchildren.

    Boey, C; Yap, S; Goh, K L

    2000-04-01

    To determine the prevalence of recurrent abdominal pain (RAP) among Malaysian school children aged from 11 to 16 years. A preliminary cross-sectional survey in which three urban schools and three rural schools were selected randomly. Two classes were selected randomly from each year. A questionnaire was given to each child asking him or her about whether they had experienced abdominal pain occurring at least three times over a period of at least 3 months, interfering with normal daily activity. 1 Interfering with normal daily activity was defined as missing school and/or having to stop doing a routine daily activity on account of the pain. Girls whose pains were related to periods were excluded. After the forms had been completed, each child was again interviewed to ensure that Apley's criteria1 was fulfilled in cases of RAP. The overall prevalence of RAP among 1549 schoolchildren (764 boys; 785 girls) was 10.2% (95% confidence interval (CI), 8.8-11.8). There appeared to be a higher prevalence in rural schoolchildren (P = 0.008; odds ratio (OR) 1.58), in those with a lower family income (P family size. : In spite of differences in time and culture, the overall prevalence of 10.2% found in this study is similar to that determined by Apley.1 There are significant differences in the prevalence of RAP between children from rural and urban schools, among children with different family incomes and among children whose parents have different educational backgrounds.

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

    Renata C. Franzon

    2002-09-01

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

  7. The Subcutaneous Abdominal Fat and Not the Intraabdominal Fat Compartment Is Associated with Anovulation in Women with Obesity and Infertility

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

    Context: Abdominal fat contributes to anovulation. Objective: We compared body fat distribution measurements and their contribution to anovulation in obese ovulatory and anovulatory infertile women. Design: Seventeen ovulatory and 40 anovulatory women (age, 30 +/- 4 yr; body mass index, 37.7 +/- 6.1

  8. Frequency of helicobacter pylori (hp) infection in children with recurrent abdominal pain (rap)

    Mahmud, S.; Ali, S.

    2015-01-01

    To study the frequency of Helicobacter Pylori (HP) infection among children with recurrent abdominal pain (RAP) Study Design: Cross-sectional comparative study. Place and Duration of Study: Military Hospital (MH), Rawalpindi from December 2011 to February 2012. Patients and Methods: One hundred children of either gender aged 2 to 12 years presenting with RAP were tested for HP at Paediatric OPD MH, Rawalpindi who consented to participate in the study. Those children who tested positive for Helicobacter Pylori Stool Antigen Test (HPSAT) were labeled as those having Hp infection. The stool assay was performed using the HpSAT kit and the socio-demographic and clinical profiles of children were associated. Results: Out of 100 children included in the study HpSAT was positive in 38% children. Frequency of Hp infection was significantly associated with source of drinking water (p = 0.014), socioeconomic status (p = 0.001) and positive family history of yspepsia (p= 0.023). While age and gender have no significant association with HP infection. Conclusion: Hp infection is very common in children presenting with RAP in our Paediatric OPD. Children with family history of dyspepsia, from low socioeconomic class and those drinking filtered water are at greater risk for HP infection. It is recommended that children from other populations in our country should also be tested in their medical health facilities in order to have a wider analysis of this problem in our setup. (author)

  9. Study of H. pylori infection in children with recurrent abdominal pain attending the pediatrics outpatient clinic of Zagazig University Hospitals.

    Badr, M A; El-Saadany, Hosam F; Ali, Adel S A; Abdelrahman, D

    2012-12-01

    This study assessed the prevalence of H. pylori infection in children with recurrent abdominal pain attending the Outpatient Pediatric Clinic of Zagazig University Hospitals. The study was conducted on 100 children suffering from different GIT symptoms mainly recurrent abdominal pain, they were categorized into 3 categories according to their ages. First category below 5 years, second category between 5 and 10 years and last category above 10 years. All subjects underwent full history taking, clinical examination and laboratory investigations. Protozoa infection was in 29% of patients, helminthes 10%, chronic constipation 4% and UTI 4%. The patients with apparent etiology were excluded. The data do not support the hypothesis that there is a direct role for H. pylori infection as a causative agent for Recurrent Abdominal Pain (RAP) in children. The mean +/- SD of age of patients were 5.7 +/- 3.7, with range of 1:18 years. Male to female ratio was 1:1.1. H. pylori serum IgG antibodies were in 26 patients (43.3%) and 24 controls (p = 0.71), and H. pylori stool Ag in stool of 22 cases and 20 controls (p = 0.7).

  10. Efficacy and Safety of Drotaverine Hydrochloride in Children with Recurrent Abdominal Pain: A Randomized Placebo Controlled Trial.

    Narang, Manish; Shah, Dheeraj; Akhtar, Hina

    2015-10-01

    To evaluate the efficacy and safety of Drotaverine hydrochroride in children with recurrent abdominal pain. Double blind, randomized placebo-controlled trial. Pediatric Gastroenterology clinic of a teaching hospital. 132 children (age 4-12 y) with recurrent abdominal pain (Apley Criteria) randomized to receivedrotaverine (n=66) or placebo (n=66) orally. Children between 4-6 years of age received 10 mL syrup orally (20 mg drotaverine hydrochloride or placebo) thrice daily for 4 weeks while children >6 years of age received one tablet orally (40 mg drotaverine hydrochloride or placebo) thrice daily for 4 weeks. Primary: Number of episodes of pain during 4 weeks of use of drug/placebo and number of pain-free days. Secondary: Number of school days missed during the study period, parental satisfaction (on a Likert scale), and occurrence of solicited adverse effects. Reduction in number of episodes of abdominal pain [mean (SD) number of episodes 10.3 (14) vs 21.6 (32.4); P=0.01] and lesser school absence [mean (SD) number of school days missed 0.25 (0.85) vs 0.71 (1.59); P=0.05] was noticed in children receiving drotaverine in comparison to those who received placebo. The number of pain-free days, were comparable in two groups [17.4 (8.2) vs 15.6 (8.7); P=0.23]. Significant improvement in parental satisfaction score was noticed on Likert scale by estimation of mood, activity, alertness, comfort and fluid intake. Frequency of adverse events during follow-up period was comparable between children receiving drotaverine or placebo (46.9% vs 46.7%; P=0.98). Drotaverine hydrochloride is an effective and safe pharmaceutical agent in the management of recurrent abdominal pain in children.

  11. Correlation among academic performance, recurrent abdominal pain and other factors in Year-6 urban primary-school children in Malaysia.

    Boey, C C M; Omar, A; Arul Phillips, J

    2003-07-01

    The present study aimed to investigate the extent to which recurrent abdominal pain and other factors were associated with academic achievement among Year-6 (12 years of age) schoolchildren. The present study was a cross-sectional survey conducted from September to November 2001. Schoolchildren were recruited from primary schools that were selected randomly from a list of all primary schools in Petaling Jaya, Malaysia, using random sampling numbers. Information concerning recurrent abdominal pain, socio-economic status, life events, demographic and other details was obtained using a combination of questionnaires and interviews. Academic achievement was assessed using a score based on the Malaysian Primary School Achievement Examination. An overall score at or above the mean was taken to indicate high academic achievement while a score below the mean indicated poor academic achievement. A total of 1971 children were studied (958 boys and 1013 girls: 1047 Malays, 513 Chinese and 411 Indians). Of these children, 456 (23.1%) fulfilled the criteria for recurrent abdominal pain. Using the method of binary logistic regression analysis, the following factors were found to be independently associated with poor academic performance: a low socio-economic status (odds ratio (OR) 1.30; 95% confidence interval (CI) 1.25-1.35); male sex (OR 1.61; 95% CI 1.26-2.05); the death of a close relative (OR 2.22; 95% CI 1.73-2.85); the divorce or separation of parents (OR 3.05; 95% CI 1.73-5.40); the commencement of work by the mother (OR 1.34; 95% CI 1.02-1.76); hospitalization of the child in the 12 months prior to the study (OR 1.83; 95% CI 1.12-3.01); lack of health-care consultation (OR 1.80; 95% CI 1.36-2.36); missing breakfast (OR 1.47; 95% CI 1.07-2.02); and lack of kindergarten education (OR 1.35; 95% CI 1.04-1.75). Many factors, such as socio-economic status and recent life events, were associated with poor academic performance. Recurrent abdominal pain did not correlate

  12. Intra-abdominal recurrence of colorectal cancer detected by radioimmunoguided surgery (RIGS system)

    Sardi, A.; Workman, M.; Mojzisik, C.; Hinkle, G.; Nieroda, C.; Martin, E.W. Jr.

    1989-01-01

    Since 1986, 32 patients with metastatic colorectal cancer have undergone second-look radioimmunoguided surgery (RIGS system). The primary tumor was located in the right and transverse colon in 11 patients, left and sigmoid colon in 16, and rectum in five. The carcinoembryonic antigen level was elevated in 30 patients (94%); all patients underwent a computed tomographic scan of the abdomen and pelvis. The overall sensitivity of the computed tomographic scan was 41% (abdomen other than liver, 27%; liver, 58%; and pelvis, 22%). The RIGS system identified recurrent tumor in 81% of the patients. The most common site of metastasis was the liver (41%), independent of the primary location. Local/regional recurrences alone accounted for 40% of all recurrences. In six patients (18%), recurrent tumor was found only with the RIGS system. The RIGS system is more dependable in localizing clinically obscure metastases than other methods, and carcinoembryonic antigen testing remains the most accurate preoperative method to indicate suspected recurrences

  13. Abdominal Compartment Syndrome complicating massive ...

    L'operation chirurgicale a permis d'établir que la tentative infructueuse de réanimation par une perfusion agressive n'est pas en fait due à une hypovolémie en soi, mais à l'hypertension intra-abdominale provoquant le SCA. Les leçons tirées de ce cas mettent un accent sur la nécessité d'une prise de conscience à propos ...

  14. Abdominal Compartment Syndrome complicating massive ...

    L'operation chirurgicale a permis d' tablir que la tentative infructueuse de r animation par une perfusion agressive n'est pas en fait due une hypovol mie en soi, mais l'hypertension intra-abdominale provoquant le SCA. Les le ons tir es de ce cas mettent un accent sur la n cessit d'une prise de conscience ...

  15. 38-year-old woman with recurrent abdominal pain, but no fever

    Iwata, Kentaro; Toma, Tomoko; Yachie, Akihiro

    2012-01-01

    Kentaro Iwata1, Tomoko Toma2, Akihiro Yachie21Department of Infectious Diseases, Kobe University Hospital, Kobe, Japan; 2Department of Pediatrics, Graduate School of Medical Science and School of Medicine, Kanazawa University, Kanazawa, JapanAbstract: A 38-year-old woman presented with 2 days history of left-flank pain. She had similar episodes of abdominal pain as well as chest pain several times, but symptoms disappeared spontaneously. Each time she developed pain, there was no fever. After...

  16. The prevalence of recurrent abdominal pain and some relative factors among children beginning primary school in Bushehr port

    Gholamreza Pouladfar

    2005-02-01

    Full Text Available Recurrent abdominal pain (RAP is a common problem in children and adolescence. The functional abdominal pain is the most common cause of RAP. The conceptual models of RAP are multivariate and acknowledge the contributions of a variety of biological, psychological, and social factors. Among the 6-7 year-old population of Bushehr port, 485 (50.1% male, 49.9%female children starting primary school were randomly selected. Questionnaires were completed by direct interview during the National Program of Health Surveillance of Schoolchildren in 2000. According to Apley's criteria, 49 children had RAP (9.1% male and 11.2% female. Abdominal pain pattern such as frequency, duration, location, radiation, associated symptoms was relatively similar to other investigations. The signs of environmental reinforcement of pain behavior such as specific attention and medication at time of pain were commonly observed (32.6% and 71.4%, respectively. Prolonged duration of involvement (73.5%, more than one year and frequent referral to physician (30.6%, at least three referral were detected. Some psychosocial stress such as father unemployment and history of irritable bowel syndrome (IBS in parents were significantly more frequent in RAP group (p values= 0.038 and 0.01, respectively. History of RAP in siblings and appendectomy, peptic disease and migraine were mildly more frequent in RAP group. Separation of one of the parents, change of address, parent education and mother employment, sibling number and order and weight and height had not significant differences between two groups. Among 22 patients, giardia cyst was detected in the stool of 4 patients (18.2 %. In conclusion, RAP is a common problem in Bushehr port and its pattern was relatively similar to other regions. The father unemployment and the history of IBS in parents, two psychosocial stresses, were associated with RAP.

  17. The Treatment of Recurrent Abdominal Pain in Children: A Controlled Comparison of Cognitive-Behavioral Family Intervention and Standard Pediatric Care.

    Sanders, Matthew R.; And Others

    1994-01-01

    Conducted controlled clinical trial involving 44 children with recurrent abdominal pain randomly assigned to cognitive-behavioral family intervention (CBFI) or standard pediatric care (SPC). Both treatments resulted in significant improvements on measures of pain intensity and pain behavior. CBFI group had higher rate of complete elimination of…

  18. Placebo- and paracetamol-controlled study on the efficacy and tolerability of hyoscine butylbromide in the treatment of patients with recurrent crampy abdominal pain

    Mueller-Lissner, S.; Tytgat, G. N.; Paulo, L. G.; Quigley, E. M. M.; Bubeck, J.; Peil, H.; Schaefer, E.

    2006-01-01

    To compare the efficacy and tolerability of oral hyoscine butylbromide (hereafter hyoscine) 10 mg t.d.s., paracetamol 500 mg t.d.s. and their fixed combination against placebo in patients with recurrent crampy abdominal pain. A total of 1637 patients were entered into a four-arm double-blind study.

  19. Case report: recurrent abdominal symptoms in a child with panhypopituitarism - there is always a differential.

    Olbrich, Laura; Schmidt, Eva; Mayatepek, Ertan; Vogel, Markus

    2016-01-01

    We report the case of a 6 year old boy suffering from adenohypophysis aplasia as well as ectopic neurohypophysis and delayed diagnosis of familial Mediterranean fever (FMF). The boy was diagnosed with panhypopituitarism during the neonatal period and suffered from recurrent episodes during the following years suggesting infections. He also showed signs of adrenal insufficiency. Finally, at the age of 6 years, an additional diagnosis of familial Mediterranean fever (FMF) was clinically suspected and later confirmed by molecular analysis. The clinical pictures of panhypopituitarism and FMF can be overlapping. It is imperative to take a detailed and accurate history in order to find the right diagnosis, particularly a precise family history. In conditions like FMF an early diagnosis is crucial, as initiation of treatment with colchicine is important to prevent long-term complications due to amyloid fibril deposition.

  20. Abdominal wall recurrence following laparoscopic surgical treatment of colorectal cancer – case report

    Kaiser de Souza Kock

    2016-10-01

    Full Text Available The treatment of colorectal diseases by videolaparoscopy (VL began in the 1990s, bringing multiple advantages in the treatment of cancers in general, especially benign tumors. Specifically, in case of colorectal cancer (CRC, the laparoscopic approach offers very attractive prospects, such as the staging of advanced lesions and palliative management of patients with incurable CCR. The most controversial aspect of this technique is the use of VL in curative resections. One questions the possibility of metastasis in portals related to tumor recurrence, as well as the violation of oncological principles. The mechanisms responsible for this phenomenon may be related to pneumoperitoneum, tissue manipulation, and biological factors. Resumo: O tratamento das doenças colorretais por vídeo-laparoscopia (VL se iniciou na década de 90, trazendo inúmeras vantagens no tratamento dos cânceres em geral, sobretudo nos cânceres benignos. Especificamente no caso do câncer colorretal (CCR o acesso laparoscópico oferece perspectivas bastante atraentes, como o estadiamento de lesões avançadas e o manuseio paliativo de pacientes com CCR incurável. O aspecto mais controverso dessa técnica reside na utilização da VL em ressecções curativas. Questiona-se a possibilidade de metástase em portais relacionadas com a recidiva tumoral, além da violação de princípios oncológicos. Os mecanismos responsáveis por esse fenômeno podem estar relacionados ao pneumoperitônio, manipulação tecidual e fatores biológicos. Keywords: Videolaparoscopy, Colorectal cancer, Recurrence, Metastasis, Palavras chave: Vídeo-Laparoscopia, Câncer Colorretal, Recidiva, Metástase

  1. Intraoperative Spillage of Favorable Histology Wilms Tumor Cells: Influence of Irradiation and Chemotherapy Regimens on Abdominal Recurrence. A Report From the National Wilms Tumor Study Group

    Kalapurakal, John A.; Li, Sierra M.; Breslow, Norman E.; Beckwith, J. Bruce; Ritchey, Michael L.; Shamberger, Robert C.; Haase, Gerald M.; Thomas, Patrick R.M.; Grundy, Paul; Green, Daniel M.; D'Angio, Giulio J.

    2010-01-01

    Purpose: We undertook this study to determine (1) the frequency with which spilled tumor cells of favorable histology produced intra-abdominal disease in patients treated with differing chemotherapy regimens and abdominal radiation therapy (RT) and (2) the patterns of relapse and outcomes in such patients. Methods and Materials: The influence of RT dose (0, 10, and 20 Gy), RT fields (flank, whole abdomen), and chemotherapy with dactinomycin and vincristine (2 drugs) vs. added doxorubicin (three drugs) on intra-abdominal tumor recurrence rates was analyzed by logistic regression in 450 patients. Each patient was considered at risk for two types of failure: flank and subdiaphragmatic beyond-flank recurrence, with the correlation between the two outcomes accounted for in the analyses. Results: The crude odds ratio for the risk of recurrence relative to no RT was 0.35 (0.15-0.78) for 10Gy and 0.08 (0.01-0.58) for 20Gy. The odds ratio for the risk of recurrence for doxorubicin to two drugs after adjusting for RT was not significant. For Stage II patients (NWTS-4), the 8-year event rates with and without spillage, respectively, were 79% and 87% for relapse-free survival (p = 0.07) and 90% and 95% for overall survival (p = 0.04). Conclusions: Irradiation (10 Gy or 20 Gy) reduced abdominal tumor recurrence rates after tumor spillage. Tumor spillage in Stage II patients reduced relapse-free survival and overall survival, but only the latter was of statistical significance. These data provide a basis for assessing the risks vs. benefits when considering treatment for children with favorable histology Wilms tumor and surgical spillage.

  2. Stereotactic body radiation therapy for patients with recurrent pancreatic adenocarcinoma at the abdominal lymph nodes or postoperative stump including pancreatic stump and other stump

    Zeng XL

    2016-06-01

    Full Text Available Xian-Liang Zeng,* Huan-Huan Wang,* Mao-Bin Meng, Zhi-Qiang Wu, Yong-Chun Song, Hong-Qing Zhuang, Dong Qian, Feng-Tong Li, Lu-Jun Zhao, Zhi-Yong Yuan, Ping Wang Department of Radiation Oncology, Tianjin’s Clinical Research Center for Cancer and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, People’s Republic of China *These authors contributed equally to this work Background and aim: The aim of this study is to evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT using CyberKnife in the treatment of patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery. Patients and methods: Between October 1, 2006 and May 1, 2015, patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery were enrolled and treated with SBRT at our hospital. The primary end point was local control rate after SBRT. Secondary end points were overall survival, time to symptom alleviation, and toxicity, assessed using the Common Terminology Criteria for Adverse Events version 4.0. Results: Twenty-four patients with 24 lesions (17 abdominal lymph nodes and seven stumps were treated with SBRT, of which five patients presented with abdominal lymph nodes and synchronous metastases in the liver and lung. The 6-, 12-, and 24-month actuarial local control rates were 95.2%, 83.8%, and 62.1%, respectively. For the entire cohort, the median overall survival from diagnosis and SBRT was 28.9 and 12.2 months, respectively. Symptom alleviation was observed in eleven of 14 patients (78.6% within a median of 8 days (range, 1–14 days after SBRT. Nine patients (37.5% experienced Common Terminology Criteria for Adverse Events version 4.0 grade 1–2 acute toxicities; one patient experienced grade 3 acute toxicity due to thrombocytopenia. Conclusion: SBRT is a safe and

  3. Patellofemoral compartment

    Brown, T.; Quinn, S.F.; Erickson, S.J.; Cox, I.

    1990-01-01

    This paper evaluates the normal and abnormal patellofemoral compartment with axial MR imaging. Anatomic cryotome sections of the patellofemoral compartment were correlated with the corresponding MR images for identification of ligamentous structures and cartilaginous surfaces. Two hundred fifty-four patients who underwent both arthroscopy and axial MR imaging of the patellofemoral compartment underwent axial MR examinations, which included gradient-echo (TR 23, TE 14, flip angle 30 degrees), T1- weighted (TR 400, TE 20), and proton and T2-weighted (2,500/20/80) sequences. The results from the cryotome-MR correlation show that axial MR images of the patellofemoral compartment accurately depict the major ligamentous and cartilaginous components. The MR arthroscopic correlation showed that all pulse sequences were unreliable in depicting the more superficial changes of chondromalacia and the evaluation on synovial plica

  4. Compartment syndromes

    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.

  5. [Application of electrogastrography in pediatrics. Part II. The incidence of disturbed gastric myoelectrical activity in children suffering from recurrent abdominal pain].

    Maliszewska, Iwona; Krusiec-Swidergoł, Beata; Kasicka-Jonderko, Anna; Jonderko, Krzysztof; Błońska-Fajfrowska, Barbara

    2007-01-01

    The study was devoted to determine the incidence of an abnormal gastric myoelectrical activity (GMA) in children suffering from recurrent abdominal pain. Surface electrogastrograms were taken in the interdigestive state and after a meal stimulation in 187 children referred to the laboratory with the diagnosis of recurrent abdominal pain. The cohort comprised the following subgroups: age 6-11 years (33 boys and 36 girls), age 12-18 years (28 boys and 90 girls). Continuous variables characterizing quantitatively an electrogastrogram were recoded into categorical data sets, which were used further for construction of an arbitrary scale reflecting disturbances of an electrogastrographic recording: score 0--normal, score 1-2, 3-4, and 5-6 corresponding to a light, moderate, and severe disturbance of the GMA. Abnormal electrogastrograms were found in just over a half of the examined children (54.5%). Nevertheless, light abnormalities (score 1-2) were predominant--42.8% of the whole cohort. Moderate abnormalities were revealed in almost every eight patient (11.8%), whereas no case of severely disturbed GMA was disclosed. On the other hand as much as 45.5% children did not exhibit any abnormality of the electrogastrogram. No statistically significant differences were found when the frequency distributions of particular degrees of the GMA disturbance were compared among groups of different age and gender. A disclosure that an abnormal electrogastrogram is encountered in just over a half of the patients and the predominance of light disturbances within this group, implies that disturbed GMA is neither an inherent nor a pathognomonic pathological finding of the clinical picture of recurrent abdominal pain in children.

  6. Association of CTRC and SPINK1 Gene Variants with Recurrent Hospitalizations for Pancreatitis or Acute Abdominal Pain in Lipoprotein Lipase Deficiency

    Karine eTremblay

    2014-04-01

    Full Text Available Background: There are important inter-individual variations in the incidence and severity of acute pancreatitis in patients with severe hypertriglyceridemia. Several genes involved in triglyceride-rich lipoprotein metabolism or serine proteases pathways are known to influence the risk of pancreatitis. Aim: To evaluate the association between genes regulating serine proteases, chymotrypsin C (CTRC and serine peptidase inhibitor kazal type1 (SPINK1, and recurrence of hospitalizations for acute pancreatitis or severe abdominal pain in patients with Lipoprotein Lipase deficiency (LPLD, a rare and extreme monogenic model of severe hypertriglyceridemia and pancreatitis. Method: The CTRC and SPINK1 genes promoter and coding regions sequencing has been performed in a sample of 38 LPLD adults (22 men and 16 women and 100 controls (53 men and 47 women. Estimation of the association of CTRC and SPINK1 gene variants or combinations of variants with history of hospitalizations for pancreatitis or acute abdominal pain in LPLD was investigated using non parametric analyses with correction for multiple testing and logistic regression models controlling for age, gender, family history and life habits. Results: Gene sequencing followed by genotype-stratified analyses of the CTRC and SPINK1 genes in LPLD and controls revealed a positive association between recurrence of hospitalizations and the rs545634 (CTRC - rs11319 (SPINK1 combination (OR = 41.4 [CI: 2.0-848.0]; p=0.016. In all models, a positive family history of pancreatitis was a significant predictor of recurrent hospitalizations independently of the contribution of SPINK1 or CTRC (pConclusion: These results suggest that a positive family history of pancreatitis and genetic markers in the serine protease pathways could be associated with a risk of recurrent hospitalization for acute pancreatitis in severe hypertriglyceridemia due to LPLD.

  7. Children in pain: recurrent back pain, abdominal pain, and headache in children and adolescents in a four-year-period.

    van Gessel, Hester; Gassmann, Jennifer; Kröner-Herwig, Birgit

    2011-06-01

    To analyze the development of recurrent pain in 3 body locations in children and adolescents (baseline age, 9 to 14 years) in a 4-year period. In a large population-based longitudinal epidemiological study data was collected through annual postal questionnaires (longitudinal, n = 2025). Descriptive statistics and generalized estimating equations were used. Girls were more likely to report recurrent pain, demonstrated a steeper development during the 4-year period, and reported multiple pain more often than boys. Younger children reported less recurrent pain, but displayed a steeper trend of increasing prevalence rates as they grew older. Older children illustrated a more stable development of recurrent pain and reported multiple pain more often. Disability experienced because of recurrent pain was related strongest to pain intensity. Stable patterns of pain were related to higher intensity and disability reports. The children experienced headache as the most disabling of the 3 pains. The results show that boys and girls report recurrent pain in different patterns in the years. To identify risk factors, analysis should be performed separately for boys and girls. Furthermore, it is recommended to include children before the age of 9 years in a prevention study. Copyright © 2011 Mosby, Inc. All rights reserved.

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

    Magda Lourenço Fernandes

    2009-10-01

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

  9. Extra-anatomic bypass for recurrent abdominal aortic and renal in-stent stenoses following radiotherapy for neuroblastoma.

    Luehr, Maximilian; Siepe, Matthias; Beyersdorf, Friedhelm; Schlensak, Christian

    2009-04-01

    We describe the case of an 11-year-old girl with an abdominal neuroblastoma which was operated and intraoperatively irradiated nine years ago. After six years, she developed stenoses of the infrarenal abdominal aorta and both renal arteries. Initial treatment of the stenosed vessels comprised endovascular balloon dilatations and repeated stent-graft implantations, including drug eluting stents. However, severe in-stent stenoses occurred during follow-up and the girl developed acute renal failure. Open surgery was performed with two extra-anatomic bypasses, a thoracic-to-abdominal aortic bypass and a left iliac-to-renal bypass, on an urgent basis. The postoperative course was uneventful and the patient was discharged home two weeks after the operation with full recovery of renal function. We conclude that endovascular stent-graft placement in children can only be a palliative treatment due to outgrowing of the stent-graft and the potential risk of re-stenosis, especially after a history of irradiation. Vascular surgery with placement of extra-anatomic bypasses will provide a definite treatment.

  10. Study of biological compartments

    Rocha, A.F.G. da

    1976-01-01

    The several types of biological compartments are studied such as monocompartmental system, one-compartment balanced system irreversible fluxes, two closed compartment system, three compartment systems, catenary systems and mammilary systems [pt

  11. Intra-abdominal hypertension and the abdominal compartment ...

    2007-02-08

    Feb 8, 2007 ... administration of injury on duty claims to the Compensation Fund. Alexander Forbes Compensation Technologies. Whelmar van Tonder. 083 395 1609 (T) 012 425 4137 (F) vantonderw@aforbes.co.za www.afct.co.za. We will finance and/or manage your COID claims resulting in immediate cashflow.

  12. The predictive value of childhood recurrent abdominal pain for adult emotional disorders, and the influence of negative cognitive style. Findings from a cohort study.

    Kate Stein

    Full Text Available Recurrent abdominal pain (RAP in childhood is common, with no explanatory pathology identified in the majority of cases. Previous studies have consistently demonstrated an association between childhood RAP and later emotional distress disorders. The aim of this study was to replicate this finding through the analysis of a large dataset, and explore how a negative style of thinking could potentially influence this relationship.The Avon Longitudinal Study of Parents and Children (ALSPAC is a population cohort of children born in the Avon area of the UK, between 1991-1992. Data on childhood RAP was collected via maternal reports at 3, 4, 7 and 9 years. Mood, anxiety and cognitive style were measured at age 18. We controlled for various confounding factors, including maternal anxiety and the child's pre-existing psychopathology. Logistic regression models were used to examine associations, and moderation effects of cognitive style were analysed using likelihood ratios.Experiencing RAP at any one time-point is associated with an increased odds of depression and/or anxiety disorder at 18 (OR = 1.41, 95% CI 1.09-1.83. We found a dose-response relationship and each additional marker of RAP was associated with a 26% (CI: 7% to 47% increase in risk of having a mood and/or anxiety disorder. Individuals who attribute adversity to global, stable or personal factors were at amplified risk.Childhood RAP predicts depression and anxiety disorders at 18 and should be targeted for early intervention. Individuals with a negative cognitive style may be particularly vulnerable, suggesting that cognitive interpretations of physical symptoms could play an important role in long-term health outcomes.

  13. Tuberculosis abdominal Abdominal tuberculosis

    T. Rubio; M. T. Gaztelu; A. Calvo; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría

    2005-01-01

    La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...

  14. Role of FDG-PET in the Diagnosis of Recurrence and Assessment of Therapeutic Response in Cervical Cancer and Ovarian Cancer Patients: Comparison of Diagnostic Report between PET, Abdominal CT and Tumor Marker

    Han, You Mie; Choe, Jae Gol; Kang, Bung Chul

    2008-01-01

    We aimed to assess the role of positron emission tomography using fluorodeoxyglucose (FDG-PET) in the diagnosis of recurrence or the assessment of therapeutic response in cervical and ovarian cancer patients through making a comparison between FDG-PET, abdominal computed tomography (CT) and serum tumor marker. We included 103 cases (67 patients) performed FDG-PET and abdominal CT. There were 42 cervical cancers and 61 ovarian cancers. We retrospectively reviewed the interpretations of PET and CT images as well as the level of tumor marker. We calculated their sensitivity, specificity, positive predictive value and negative predictive value for these three modalities. And then we analyzed the differences between these three modalities. Tumor recurrences were diagnosed in 37 cases (11 cervical cancers and 26 ovarian cancers). For PET, CT and tumor marker, in cervical cancer group, sensitivity was 100% (11/11), 54.5% (6/11) and 81.1% (9/11), respectively. And specificity was 93.6% (29/31), 93.6% (29/31) and 100% (31/31). In ovarian cancer group, sensitivity was 96.2% (25/26), 84.6% (22/26) and 80.8% (21/26), and specificity was 94.3% (33/35), 94.3% (33/35), 94.3% (33/35). PET was highly sensitive to detect the intraperitoneal and extraperitoneal metastasis with the help of the CT images to localize the lesions. However, CT had limitations in differentiation of the recurrent tumor from benign fibrotic tissue, identification of viable tumors at the interface of tissues, and detecting extraperitoneal lesions. FDG-PET can be an essential modality to detect the recurrent or residual tumors in gynecologic cancer patients because of its great field of the application and high sensitivity

  15. ACUTE COMPARTMENT SYNDROME

    muscle destruction, muscle fibrosis, contractures and permanent disability and at worst case scenario of amputation (3,4). As reported by Frink et al (3) on their study on acute compartment syndrome it can occur even when there is no fracture. Also general surgeons have reported acute compartment syndrome.

  16. Obesity-Associated Abdominal Elephantiasis

    Ritesh Kohli

    2013-01-01

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

  17. Recurrent abdominal pain as the presentation of tumor necrosis factor receptor-associated periodic syndrome (TRAPS) in an Asian girl: a case report and review of the literature.

    Chen, Yun-Ju; Yu, Hsin-Hui; Yang, Yao-Hsu; Lau, Yu-Lung; Lee, Wen-I; Chiang, Bor-Luen

    2014-12-01

    Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is characterized by periodic fever, cutaneous rash, conjunctivitis, lymphadenopathy, abdominal pain, myalgia, and arthralgia. It is a rare autosomal dominant disease and strongly associated with heterozygous mutations in the tumor necrosis factor (TNF) receptor super family 1A (TNFRSF1A) gene. It is believed to be more common in Western countries than in Asian countries. Here, we present the case of a 14-year-old girl with periodic fever and abdominal pain with elevation of inflammatory markers for 2 years. After extensive work-up of infectious etiology with negative results, the diagnosis of TRAPS was made although no gene mutations were identified in the TNFRSF1A gene, MVK gene, and NALP3/CIAS1 gene. She had partial clinical response to corticosteroids and immunomodulatory agents. However, the treatment response to TNF-α inhibitor etanercept was dramatic. She has remained symptom free under regular weekly to biweekly etanercept treatment for 2 years. We also reviewed the related literature and summarized the data of 10 Asian cases of TRAPS. Copyright © 2012. Published by Elsevier B.V.

  18. Congenital Abdominal Wall Defects

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

    2016-01-01

    related complications; and post-discharge gastrointestinal surgery. RESULTS: GDM was placed in 34 (gastroschisis=27, omphalocele=7) patients during the study period. Complete closure of the fascia was obtained in one patient with omphalocele and in 22 patients with gastroschisis. Mesh related surgical...... 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...

  19. Intraabdominal Compartment Syndrome Complicating Transurethral Resection of Bladder Tumor

    Sachin Narain

    2012-01-01

    Full Text Available Abdominal compartment syndrome can result from many different causes. We present a case where this dangerous syndrome occurred in the operating room during a transurethral resection of a bladder tumor. It was initially recognized by an elevation in the peak inspiratory pressure. We report the typical physiologic changes that occur with this syndrome and its treatment options.

  20. Economics of abdominal wall reconstruction.

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Abdominal trauma

    Giordany, B.R.

    1985-01-01

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

  2. Compartment syndrome without pain!

    O'Sullivan, M J

    2012-02-03

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

  3. Abdominal Pain

    ... I find more information and related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Gastro Kids , a ...

  4. Abdominal epilepsy

    Hasan, N.; Razzaq, A.

    2004-01-01

    Abdominal epilepsy (AE) is a rather uncommon clinical entity in children that might create diagnostic confusion especially when it lacks the typical manifestations of an epileptic seizure. We report the case of a young boy having apparently unexplained episodes of paroxysmal abdominal symptoms with no other suggestion of an underlying epileptic disorder. The case also explains how the clinical presentation can be misleading unless a high index of suspicion is maintained to reach the ultimate diagnosis. (author)

  5. Modeling of compartment fire

    Sathiah, P.; Siccama, A.; Visser, D.; Komen, E.

    2011-01-01

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

  6. Pilot study of continuous-infusion 5-fluorouracil, oral leucovorin, and upper-abdominal radiation therapy in patients with locally advanced residual or recurrent upper gastrointestinal or extrapelvic colon cancer

    Martenson, James A.; Swaminathan, Revathi; Burch, Patrick A.; Santala, Roger G.; Schroeder, Georgene; Pitot, Henry C.; Wright, Keith; Kugler, John W.; Stella, Philip J.; Garton, Graciela R.

    1997-01-01

    Purpose: The purpose of this study was to develop a satisfactorily tolerated regimen of radiation therapy, continuous infusion 5-fluorouracil, and leucovorin in patients with locally advanced upper-abdominal gastrointestinal cancer. Methods and Materials: Patients with locally advanced or locally recurrent gastric, pancreatic, or extrapelvic colon cancer were eligible for this study. Radiation therapy consisted of 45 Gy in 25 fractions to the tumor and regional lymph nodes, followed by 5.4-9 Gy in three to five fractions to the tumor. Treatment with leucovorin, 10 mg orally daily, and continuous infusion 5-fluorouracil was initiated on the first day of radiation therapy. 5-Fluorouracil was administered at an initial daily dose of 125 mg/m 2 , with dose escalation planned in 25-mg increments, depending on patient tolerance. Results: Twenty-one evaluable patients participated in this study. Six were treated at the initial daily 5-fluorouracil dose of 125 mg/m 2 . One patient experienced Grade 4 anorexia and nausea. No other Grade ≥3 toxicity was observed at this dose. Fifteen evaluable patients were entered at a planned 5-fluorouracil dose of 150 mg/m 2 daily; 6 of them experienced Grade 3 toxicity, and none experienced Grade ≥ 4 toxicity. Grade 3 toxicities and the number of patients who developed each were: vomiting (three patients); nausea (two patients); diarrhea (two patients); and skin toxicity, hand-foot syndrome, catheter-related infection, and stomatitis in one patient each. Four of the six patients who experienced Grade 3 toxicity developed more than one type of Grade 3 toxicity. Conclusions: In patients with upper-abdominal gastrointestinal cancer, continuous infusion 5-fluorouracil (150 mg/m 2 daily), leucovorin (10 mg orally daily), and radiation therapy (50-54 Gy) resulted in a 40% rate of severe toxicity but no life-threatening toxicity. This clinical trial excludes, with 90% confidence, a 20% risk of Grade 4 toxicity with this combination. The 40

  7. Kidney compartment model

    Gullberg, G.T.

    1976-09-01

    A multiparameter kidney compartment model which quantitates the amount of iodohippurate concentration as a function of time in the blood, tissue, kidneys and bladder is developed from a system of differential equations which represent first order kinetics. The kinetic data are obtained using a gamma camera and an HP5407 computer system which allows one to delineate areas of interest for the blood and tissue, kidneys, and bladder thus separating the data into four data sets. The estimated tubular transit times have a high ratio of the signal to the variance whereas the estimates of the amount of iodohippurate in the blood, tissue and kidneys have a low ratio of the signal to the variance. Application of this model to patient data requires better statistics than available with conventional 131 I-hippurate doses; thus a true test of the efficacy awaits availability of 123 I-hippurate

  8. Abdominal elephantiasis: a case report.

    Hanna, Dominique; Cloutier, Richard; Lapointe, Roch; Desgagné, Antoine

    2004-01-01

    Elephantiasis is a well-known condition in dermatology usually affecting the legs and external genitalia. It is characterized by chronic inflammation and obstruction of the lymphatic channels and by hypertrophy of the skin and subcutaneous tissues. The etiology is either idiopathic or caused by a variety of conditions such as chronic filarial disease, leprosy, leishmaniasis, and chronic recurrent cellulites. Elephantiasis of the abdominal wall is very rare. A complete review of the English and French literature showed only two cases reported in 1966 and 1973, respectively. We report a third case of abdominal elephantiasis and we briefly review this entity. We present the case of a 51-year-old woman who had progressively developed an enormous pediculated abdominal mass hanging down her knees. The skin was thickened, hyperpigmented, and fissured. She had a history of multiple abdominal cellulites. She underwent an abdominal lipectomy. Histopathology of the specimen confirmed the diagnosis of abdominal elephantiasis. Abdominal elephantiasis is a rare disease that represents end-stage failure of lymph drainage. Lipectomy should be considered in the management of this condition.

  9. Abdominal Sepsis.

    De Waele, Jan J

    2016-08-01

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

  10. Epidemiology, diagnosis and management of functional abdominal pain in children: A look beyond the belly

    Korterink, J.J.

    2015-01-01

    Chronic abdominal pain represents a common problem in children. In almost 90% of children presenting with chronic abdominal pain, no organic cause is found and a diagnosis of functional abdominal pain is made. Initially this condition was referred to as ‘recurrent abdominal pain’ by Apley and Naish and it is currently defined as abdominal pain-related functional gastrointestinal disorders (AP-FGIDs); divided into functional dyspepsia (FD), irritable bowel syndrome (IBS), abdominal migraine (A...

  11. Abdominal migraine in childhood: a review

    Scicchitano B

    2014-08-01

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

  12. Abdominal emergencies during pregnancy.

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management. Copyright © 2015. Published by Elsevier Masson SAS.

  13. Epidemiology, diagnosis and management of functional abdominal pain in children: A look beyond the belly

    Korterink, J.J.

    2015-01-01

    Chronic abdominal pain represents a common problem in children. In almost 90% of children presenting with chronic abdominal pain, no organic cause is found and a diagnosis of functional abdominal pain is made. Initially this condition was referred to as ‘recurrent abdominal pain’ by Apley and Naish

  14. Abdominal emergencies

    Raissaki, M.

    2012-01-01

    Full text: There are numerous conditions that affect mainly or exclusively the pediatric population. These constitute true emergencies, related to patient's health. Delay in diagnosis and treatment of abdominal non-traumatic emergencies may result in rapid deterioration, peritonitis, sepsis, even death or in severe complications with subsequent morbidity. Abdominal emergencies in children mostly present with pain, tenderness, occasionally coupled by vomiting, fever, abdominal distension, and failure to pass meconium or stools. Diarrhea, blood per rectum, abnormal laboratory tests and lethargy may also be manifestations of acute abdominal conditions. Abdominal emergencies have a different aetiology, depending on age and whether the pain is acute or chronic. Symptoms have to be matched with age and gender. Newborns up to 1 months of age may have congenital diseases: atresia, low obstruction including Hirschsprung's disease, meconium ileus. Meconium plug is one of the commonest cause of low obstruction in newborns that may also develop necrotizing enterocolitis, incarcerated inguinal hernia and mid-gut volvulus. Past the immediate postnatal period, any duodenal obstruction should be considered midgut volvulus until proven otherwise and patients should undergo ultrasonography and/or properly performed upper GI contrast study that records the exact position of the deduno-jejunal junction. Infants 6 months-2 years carry the risk of intussusception, mid-gut volvulus, perforation, acute pyelonephritis. Preschool and school-aged children 2-12 years carry the risk of appendicitis, genito-urinary abnormalities including torsion, urachal abnormalities, haemolytic uremic syndrome and Henoch-Schonlein purpura. Children above 12 years suffer from the same conditions as in adults. Most conditions may affect any age despite age predilection. Abdominal solid organ ultrasonography (US) coupled with gastrointestinal ultrasonography is the principle imaging modality in radiosensitive

  15. Abdominal angina

    Becker, G.J.; Stewart, J.; Holden, R.W.; Yune, H.Y.; Mail, J.T.; Klatte, E.C.

    1988-01-01

    Abdominal angina due to occlusive disease of the mesenteric arteries has been the to become clinically manifest only in the presence of severe disease in at least two of the following vessels: celiac, SMA, and IMA. Still, many patients who gradually develop significant two-vessel disease have few or no associated symptoms. Differences in collateral circulation and in cardiac index account for some of the clinical variation. The usual clinical manifestations include severe post-prandial pain, sitophobia (fear of eating because of the anticipated symptoms), and profound weight loss. Uncommonly, diarrhea, nausea, or vomiting may be encountered. Smoking is a common historical feature. Most series document a female predilection. Aside from occasional abdominal bruits and (more commonly) findings of peripheral vascular occlusive disease, the physical exam discloses only cachexia. But the differential diagnosis of profound weight loss is extensive. Therefore, abdominal angina has always created a diagnostic challenge. Multiple imaging modalities are often employed, and a seemingly negative evaluation often culminates in biplane aortography. The latter typically reveals stenoses and/or occlusions in at least two of the three mesenteric arteries. The authors discuss how a variety of surgical treatments, including thromboendarterectomy and bypass grafting, have evolved. Recently reported results have been excellent

  16. Computed tomography, after abdominal surgery

    Vogel, H.; Toedt, H.C.

    1985-09-01

    The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which faciltated the differential diagnosis to tumor recurrency. The changes of the roentgenmorphology were not so obvious after gastrointestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolus injection. (orig.).

  17. Double-compartment wrist arthrography

    Quinn, S.F.; Pittman, C.; Belsole, R.; Greene, T.L.; Rayhack, J.; Clark, R.A.; King, P.S.

    1987-01-01

    Seventy patients with clinical wrist problems were studied with double-compartment wrist arthrography. Midcarpal and radiocarpal compartment arthrograms were obtained in all patients. Digital subtraction technique was used to subtract out contrast from the first compartmental injection. Digital technique also allowed a dynamic record of each injection, which helped determine sites of intercompartmental communication. Postarthrography exercises recorded on videotape were performed after each injection. There were 34 normal studies. Abnormalities in the other 36 patients included: scapholunate communication (n = 9), lunatotriquetral communication (n = 6), communication with tendon sheaths (n = 4), communication with distal radioulnar compartment (n = 14), abnormal synovium process (n = 9), and communication through the radial or ulnar collateral ligament (n = 3). Double-compartment wrist arthrography may provide additional information for complex problems of the wrist

  18. Dual-Compartment Inflatable Suitlock

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

    2013-01-01

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

  19. Recurrent varicocele

    Katherine Rotker

    2016-01-01

    Full Text Available Varicocele recurrence is one of the most common complications associated with varicocele repair. A systematic review was performed to evaluate varicocele recurrence rates, anatomic causes of recurrence, and methods of management of recurrent varicoceles. The PubMed database was evaluated using keywords "recurrent" and "varicocele" as well as MESH criteria "recurrent" and "varicocele." Articles were not included that were not in English, represented single case reports, focused solely on subclinical varicocele, or focused solely on a pediatric population (age <18. Rates of recurrence vary with the technique of varicocele repair from 0% to 35%. Anatomy of recurrence can be defined by venography. Management of varicocele recurrence can be surgical or via embolization.

  20. Adult abdominal wall hernia in Ibadan | Ayandipo | Annals of Ibadan ...

    Background: Abdominal wall hernias are very common diseases encountered in surgical practice. Groin hernia is the commonest type of abdominal wall hernias. There are several methods of hernia repair but tension-free repair (usually with mesh) offers the least recurrent rate. Aim: To describe the clinical profile of anterior ...

  1. [Approaching a child with chronic abdominal pain

    Kollee, L.A.A.

    2003-01-01

    A detailed anamnesis and a complete physical examination are essential for establishing the cause of recurrent abdominal pain in a child. Often no medical abnormalities will be found and additional diagnostic procedures may be limited. Most cases are functional in nature or have a psychosomatic

  2. Imaging of iliopsoas compartment disease

    Rocher, L.; Saint Maurice, J.P.; Le Quen, O.; Bazille, A.; Miquel, A.; Frouge, C.; Blery, M.

    1997-01-01

    Infection, neoplastic involvement, and hemorrhage, are the most frequent pathologies that involve the ilio-psoas compartment. The extension from contiguous pathological structures and particularly digestive and urological organs, are often the origin of abscess formation or malignant tumours. The radiological findings including ultrasonography, CT, and magnetic resonance imaging, show a low specificity, which improves if the clinical history is known. The final diagnosis is confirmed by puncture or biopsy. (author)

  3. Numerical treatment of compartment models

    Einarsson, B.

    1984-11-01

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

  4. Forearm Compartment Syndrome Caused by Reperfusion Injury

    Ufuk Sayar

    2014-01-01

    Full Text Available Compartment syndrome is commonly seen following lower extremity ischemia. However, upper extremities’ compartment syndrome, especially after any vascular surgical procedures, is infrequent. Herein we report a case of an acute forearm compartment syndrome that was developed after delayed brachial artery embolectomy.

  5. Acute compartment syndrome after medial gastrocnemius tear.

    Sit, Yan Kit; Lui, Tun Hing

    2015-02-01

    Acute compartment syndrome after medial gastrocnemius tear is very rare. It can involve the superficial posterior compartment alone or progress to involve all the 4 compartments of the lower legs. Those patients with high pain tolerance and minor trauma can lead to delayed presentation. Immediate fasciotomy is the treatment of choice. Therapeutic Level IV, Case Study. © 2014 The Author(s).

  6. 14 CFR 25.787 - Stowage compartments.

    2010-01-01

    ... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Personnel and Cargo Accommodations § 25.787 Stowage compartments. (a) Each compartment for the stowage of cargo, baggage, carry-on articles, and... to compartments located below, or forward, of all occupants in the airplane. If the airplane has a...

  7. Abdominal Aortic Aneurysm (AAA)

    ... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...

  8. Recurrent Meningitis.

    Rosenberg, Jon; Galen, Benjamin T

    2017-07-01

    Recurrent meningitis is a rare clinical scenario that can be self-limiting or life threatening depending on the underlying etiology. This review describes the causes, risk factors, treatment, and prognosis for recurrent meningitis. As a general overview of a broad topic, the aim of this review is to provide clinicians with a comprehensive differential diagnosis to aide in the evaluation and management of a patient with recurrent meningitis. New developments related to understanding the pathophysiology of recurrent meningitis are as scarce as studies evaluating the treatment and prevention of this rare disorder. A trial evaluating oral valacyclovir suppression after HSV-2 meningitis did not demonstrate a benefit in preventing recurrences. The data on prophylactic antibiotics after basilar skull fractures do not support their use. Intrathecal trastuzumab has shown promise in treating leptomeningeal carcinomatosis from HER-2 positive breast cancer. Monoclonal antibodies used to treat cancer and autoimmune diseases are new potential causes of drug-induced aseptic meningitis. Despite their potential for causing recurrent meningitis, the clinical entities reviewed herein are not frequently discussed together given that they are a heterogeneous collection of unrelated, rare diseases. Epidemiologic data on recurrent meningitis are lacking. The syndrome of recurrent benign lymphocytic meningitis described by Mollaret in 1944 was later found to be closely related to HSV-2 reactivation, but HSV-2 is by no means the only etiology of recurrent aseptic meningitis. While the mainstay of treatment for recurrent meningitis is supportive care, it is paramount to ensure that reversible and treatable causes have been addressed for further prevention.

  9. Abdominal wall fat pad biopsy

    Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... is the most common method of taking an abdominal wall fat pad biopsy . The health care provider cleans the ...

  10. Bilateral post-traumatic gluteal compartment syndrome: A case report and review of literature

    Devashis Barick

    2015-01-01

    Full Text Available Gluteal compartment is a rare site for compartment syndrome. Gluteal compartment syndrome has most commonly been described in the literature as occurring after prolonged immobility associated with substance abuse, improper operative positioning, sickle cell-induced infarct, post-traumatic and spontaneous superior gluteal artery rupture, exercise, and post-arterial embolization of the internal iliac artery prior to abdominal aortic aneurysm repair. Trauma is rarely associated with this syndrome. Gluteal compartment syndrome occurs in approximately 0.9% of trauma patients. Posttraumatic gluteal compartment syndrome develops because of edema with traumatic contusions, crush injuries and hematoma formation due to blunt superior or inferior gluteal artery injuries in all compartments of the gluteal region Only 6 previous cases have been reported in the literature. Two previous cases involved positioning for urological procedures, while the other cited causes of bilateral gluteal compartment syndrome include exercise-induced, trauma, and prolonged immobilization from substance abuse. One of the most immediately devastating results of a missed compartment syndrome is the risk of the development of rhabdomyolysis with the resulting squeal of myoglobinuria, hyperkalemia, and acidosis resulting in renal failure, shock, multiple organ failure, disseminated intravascular coagulation, and possibly death. Here we report a case of posttraumatic bilateral compartment syndrome which developed secondary to pressure due to patient being trapped under a vehicle following a vehicular accident. He was operated upon and a bilateral fasciotomy was done. Although he did not develop any renal complications, the sciatic nerve palsy on the left side did not recover. The patient is still under follow up.

  11. Acute compartment syndrome caused by uncontrolled hypothyroidism.

    Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

    2017-06-01

    Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Abdominal Cocoon – A Case Report with Short Review of Literature

    Tamanna Choudhury

    2010-04-01

    Full Text Available Abdominal cocoon is a rare entity where there is encapsulation of the small bowel by a fibrous membrane causing clustering of the bowel. The exact aetiology is unclear. We report a case of a 15 year old girl with a history of recurrent colicky abdominal pain in the right lower abdomen. Clinical diagnosis was recurrent appendicitis. She underwent laparotomy for appendicular lump. Histopathological examination of the resected lump grossly and histologically revealed the features of abdominal cocoon. Key Words: Abdominal Cocoon; Sclerosing encapsulating peritonitis; Small bowel. DOI: 10.3329/bsmmuj.v2i2.4763 BSMMU J 2009; 2(2: 81-84

  13. Forearm Compartment Syndrome: Evaluation and Management.

    Kistler, Justin M; Ilyas, Asif M; Thoder, Joseph J

    2018-02-01

    Compartment syndrome of the forearm is uncommon but can have devastating consequences. Compartment syndrome is a result of osseofascial swelling leading to decreased tissue perfusion and tissue necrosis. There are numerous causes of forearm compartment syndrome and high clinical suspicion must be maintained to avoid permanent disability. The most widely recognized symptoms include pain out of proportion and pain with passive stretch of the wrist and digits. Early diagnosis and decompressive fasciotomy are essential in the treatment of forearm compartment syndrome. Closure of fasciotomy wounds can often be accomplished by primary closure but many patients require additional forms of soft tissue coverage procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Child with Abdominal Pain.

    Iyer, Rajalakshmi; Nallasamy, Karthi

    2018-01-01

    Abdominal pain is one of the common symptoms reported by children in urgent care clinics. While most children tend to have self-limiting conditions, the treating pediatrician should watch out for underlying serious causes like intestinal obstruction and perforation peritonitis, which require immediate referral to an emergency department (ED). Abdominal pain may be secondary to surgical or non-surgical causes, and will differ as per the age of the child. The common etiologies for abdominal pain presenting to an urgent care clinic are acute gastro-enteritis, constipation and functional abdominal pain; however, a variety of extra-abdominal conditions may also present as abdominal pain. Meticulous history taking and physical examination are the best tools for diagnosis, while investigations have a limited role in treating benign etiologies.

  15. Clinical aspects of lower leg compartment syndrome

    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

  16. Physicians' Abdominal Auscultation

    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...... subjects and in patients with intestinal obstruction was acceptable for a clinical examination. Abdominal auscultation is a helpful clinical examination in patients with acute abdominal pain....

  17. Recurrent vulvovaginitis.

    Powell, Anna M; Nyirjesy, Paul

    2014-10-01

    Vulvovaginitis (VV) is one of the most commonly encountered problems by a gynecologist. Many women frequently self-treat with over-the-counter medications, and may present to their health-care provider after a treatment failure. Vulvovaginal candidiasis, bacterial vaginosis, and trichomoniasis may occur as discreet or recurrent episodes, and have been associated with significant treatment cost and morbidity. We present an update on diagnostic capabilities and treatment modalities that address recurrent and refractory episodes of VV. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Acute transfusion-related abdominal injury in trauma patients: a case report.

    Michel, P; Wähnert, D; Freistühler, M; Laukoetter, M G; Rehberg, S; Raschke, M J; Garcia, P

    2016-10-19

    Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation. We report the case of an acute secondary abdominal compartment syndrome developing within 3 to 4 hours in a 74-year-old polytraumatized white woman. Although multiple fractures of her extremities and a B-type pelvic ring fracture were diagnosed by a full body computed tomography scan, no intra-abdominal injury could be detected. Hemorrhagic shock with a drop in her hemoglobin level to 5.7 g/dl was treated by massive transfusion of blood products and high doses of catecholamines. Shortly afterwards, her pulmonary gas exchange progressively deteriorated and mechanical ventilation became almost impossible with peak airway pressures of up to 60 cmH 2 O. Her abdomen appeared rigid and tense accompanied by a progressive hemodynamic decompensation necessitating mechanic cardiopulmonary resuscitation. Although preoperative computed tomography scans showed no signs of intra-abdominal fluid, a decompressive laparotomy under cardiopulmonary resuscitation conditions was performed and 2 liters of ascites-like fluid disgorged. Her hemodynamics and pulmonary ventilation improved immediately. This case report describes for the first time acute secondary abdominal compartment syndrome in a trauma patient, evolving in a very short time period. We hypothesize that the massive transfusion of blood products along with high doses of catecholamines triggered the acute

  19. Acute intestinal distress syndrome: the importance of intra-abdominal pressure.

    Malbrain, M L N G; Vidts, W; Ravyts, M; De Laet, I; De Waele, J

    2008-11-01

    This review article will focus primarily on the recent literature on abdominal compartment syndrome (ACS) as well as the definitions and recommendations published by the World Society for the Abdominal Compartment Syndrome (WSACS, www.wsacs.org). The risk factors for intra-abdominal hypertension (IAH) and the definitions regarding increased intra-abdominal pressure (IAP) will be listed, followed by a brief but comprehensive overview of the different mechanisms of end-organ dysfunction associated with IAH. Measurement techniques for IAP will be discussed, as well as recommendations for organ function support in patients with IAH. Finally, noninvasive medical management options for IAH, surgical treatment for ACS and management of the open abdomen will be briefly discussed.

  20. Retropsoas hernia as a cause of chronic abdominal pain: CT diagnosis

    Benson, J.E.; Strauch, E.D.

    1998-01-01

    Congenital retropsoas small bowel herniation is reported as the cause of long-standing recurrent abdominal pain in a teenage girl. Knowledge of this entity is important for differential diagnosis of abdominal pain, mass, or retroperitoneal gas and fluid, and for avoiding complications of percutaneous renal interventions. (orig.)

  1. Compartment syndrome in a labrador retriever

    Williams, J.; Bailey, M.Q.; Schertel, E.R.; Valentine, A.

    1994-01-01

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

  2. Multi-compartment microscopic diffusion imaging

    Kaden, Enrico; Kelm, Nathaniel D.; Carson, Robert P.; Does, Mark D.; Alexander, Daniel C.

    2016-01-01

    This paper introduces a multi-compartment model for microscopic diffusion anisotropy imaging. The aim is to estimate microscopic features specific to the intra- and extra-neurite compartments in nervous tissue unconfounded by the effects of fibre crossings and orientation dispersion, which are ubiquitous in the brain. The proposed MRI method is based on the Spherical Mean Technique (SMT), which factors out the neurite orientation distribution and thus provides direct estimates of the microsco...

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

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

    2014-01-01

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

  4. Heterotopic ossification in abdominal incision : a case report

    Yoo, Yoon Sik; Nam, Kung Sook; Hwang, Im Kyung; Kim, Heung Chul [College of Medicine, Hallym Univ., Chuncheon (Korea, Republic of)

    2001-08-01

    Heterotopic ossification in abdominal incision is a rare post-surgical sequala and a subtype of myositis ossificans traumatica. Recognition of this rare condition is important because it may be misinterpreted as a retained foreign body or incisional neoplastic recurrence. We report a case involving a 59-year-old man who presented with a palpable epigastric mass and pronounced fatigability.

  5. Chronic Abdominal Wall Pain.

    Koop, Herbert; Koprdova, Simona; Schürmann, Christine

    2016-01-29

    Chronic abdominal wall pain is a poorly recognized clinical problem despite being an important element in the differential diagnosis of abdominal pain. This review is based on pertinent articles that were retrieved by a selective search in PubMed and EMBASE employing the terms "abdominal wall pain" and "cutaneous nerve entrapment syndrome," as well as on the authors' clinical experience. In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall; in patients with previously diagnosed chronic abdominal pain who have no demonstrable pathological abnormality, this likelihood can rise as high as 30% . There have only been a small number of clinical trials of treatment for this condition. The diagnosis is made on clinical grounds, with the aid of Carnett's test. The characteristic clinical feature is strictly localized pain in the anterior abdominal wall, which is often mischaracterized as a "functional" complaint. In one study, injection of local anesthesia combined with steroids into the painful area was found to relieve pain for 4 weeks in 95% of patients. The injection of lidocaine alone brought about improvement in 83-91% of patients. Long-term pain relief ensued after a single lidocaine injection in 20-30% of patients, after repeated injections in 40-50% , and after combined lidocaine and steroid injections in up to 80% . Pain that persists despite these treatments can be treated with surgery (neurectomy). Chronic abdominal wall pain is easily diagnosed on physical examination and can often be rapidly treated. Any physician treating patients with abdominal pain should be aware of this condition. Further comparative treatment trials will be needed before a validated treatment algorithm can be established.

  6. Prolapse Recurrence after Transvaginal Mesh Removal.

    Rawlings, Tanner; Lavelle, Rebecca S; Coskun, Burhan; Alhalabi, Feras; Zimmern, Philippe E

    2015-11-01

    We determined the rate of pelvic organ prolapse recurrence after transvaginal mesh removal. Following institutional review board approval a longitudinally collected database of women undergoing transvaginal mesh removal for complications after transvaginal mesh placement with at least 1 year minimum followup was queried for pelvic organ prolapse recurrence. Recurrent prolapse was defined as greater than stage 1 on examination or the need for reoperation at the site of transvaginal mesh removal. Outcome measures were based on POP-Q (Pelvic Organ Prolapse Quantification System) at the last visit. Patients were grouped into 3 groups, including group 1--recurrent prolapse in the same compartment as transvaginal mesh removal, 2--persistent prolapse and 3--prolapse in a compartment different than transvaginal mesh removal. Of 73 women 52 met study inclusion criteria from 2007 to 2013, including 73% who presented with multiple indications for transvaginal mesh removal. The mean interval between insertion and removal was 45 months (range 10 to 165). Overall mean followup after transvaginal mesh removal was 30 months (range 12 to 84). In group 1 (recurrent prolapse) the rate was 15% (6 of 40 patients). Four women underwent surgery for recurrent prolapse at a mean 7 of months (range 5 to 10). Two patients elected observation. The rate of persistent prolapse (group 2) was 23% (12 of 52 patients). Three women underwent prolapse reoperation at a mean of 10 months (range 8 to 12). In group 3 (de novo/different compartment prolapse) the rate was 6% (3 of 52 patients). One woman underwent surgical repair at 52 months. At a mean 2.5-year followup 62% of patients (32 of 52) did not have recurrent or persistent prolapse after transvaginal mesh removal and 85% (44 of 52) did not undergo any further procedure for prolapse. Specifically for pelvic organ prolapse in the same compartment as transvaginal mesh removal 12% of patients had recurrence, of whom 8% underwent prolapse repair

  7. Clinical application of PET in abdominal cancers

    Choi, Chang Woon

    2002-01-01

    Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in the liver and the other abdominal organs, it is particularly useful for identification and characterization of the entire body simultaneously. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterizing of indeterminate soft-tissue masses. Most abdominal cancer requires surgical management. FGD PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The abdominal cancers, such as gastroesophageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea, and PET is one of the most promising and useful methodologies for the management of abdominal cancers

  8. Abdominal and Pelvic CT

    Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...

  9. Abdominal and Pelvic CT

    Full Text Available ... the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney and bladder stones. abdominal aortic ... and properly administer radiation treatments for tumors as well as monitor response to chemotherapy. top of page ...

  10. CT of abdominal abscesses

    Korobkin, M.T.

    1987-01-01

    The imaging search for a suspected abdominal abscess is common in hospitalized patients, especially after recent abdominal surgery. This paper examines the role of CT in the detection, localization, and treatment of abdominal abscess. The accuracy, limitations, and technical aspects of CT in this clinical setting are discussed. The diagnosis of an abscess is based on the demonstration of a circumscribed abnormal fluid collection. Although percutaneous aspiration with gram stain and culture is usually indicated to differentiate abscess from other fluid collections, the CT-based detection of extraluminal gas bubbles makes the diagnosis of an abscess highly likely. CT is compared with conventional radiographic studies, US, and radio-nuclide imaging. Specific CT and clinical features of abscesses in the following sites are emphasized: subphrenic space, liver, pancreas, kidneys, psoas muscle, appendix, and colonic diverticula. Most abdominal abscesses can be successfully treated with percutaneous drainage techniques. The techniques, results, and limitations of percutaneous abscess drainage are reviewed

  11. Abdominal and Pelvic CT

    Full Text Available ... intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is ... preferred for evaluation of acute abdominal conditions in babies, such as vomiting or blood in stool. For ...

  12. Abdominal and Pelvic CT

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... CT scan, an experienced radiologist can diagnose many causes of abdominal pain or injury from trauma with ...

  13. Abdominal x-ray

    Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...

  14. Abdominal cocoon: sonographic features.

    Vijayaraghavan, S Boopathy; Palanivelu, Chinnusamy; Sendhilkumar, Karuppusamy; Parthasarathi, Ramakrishnan

    2003-07-01

    An abdominal cocoon is a rare condition in which the small bowel is encased in a membrane. The diagnosis is usually established at surgery. Here we describe the sonographic features of this condition.

  15. Abdominal and Pelvic CT

    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 ...

  16. Abdominal ultrasound (image)

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

  17. Abdominal and Pelvic CT

    Full Text Available ... abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including but not limited to some liver, kidney, pancreatic, uterine or ... Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  18. Abdominal and Pelvic CT

    Full Text Available ... for tumors as well as monitor response to chemotherapy. top of page How should I prepare? You ... of acute abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including ...

  19. Abdominal tuberculosis: Imaging features

    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.

  20. Abdominal and Pelvic CT

    Full Text Available ... pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries ...

  1. Abdominal tuberculosis: Imaging features

    Pereira, Jose M.; Madureira, Antonio J.; Vieira, Alberto; Ramos, Isabel

    2005-01-01

    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

  2. Abdominal cerebrospinal fluid pseudocyst

    Pathi, Ramon; Sage, Michael; Slavotinek, John; Hanieh, Ahmad

    2004-01-01

    A case of an abdominal cerebrospinal fluid (CSF) pseudocyst in a patient with a ventriculoperitoneal shunt is reported to illustrate this known but rare complication. In the setting of a VP shunt, the frequency of abdominal CSF pseudocyst formation is approximately 3.2%, often being precipitated by a recent inflammatory or infective process or recent surgery. Larger pseudocysts tend to be sterile, whereas smaller pseudocysts are more often infected. Ultrasound and CTeach have characteristic findings Copyright (2004) Blackwell Publishing Asia Pty Ltd

  3. Imaging in Tuberculosis abdominal

    Suarez, Tatiana; Garcia, Vanessa; Tamara, Estrada; Acosta, Federico

    2010-01-01

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

  4. A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma

    Elvan Caglar Citak

    Full Text Available Abstract Cardiac angiosarcomas are extremely rare in childhood, they are rapidly progressive tumours that often present themselves as diagnostic dilemmas, resulting in delayed diagnosis. Also, extracardiac manifestations, including abdominal pain, are extremely rare in patients with intracardiac tumors. We herein present the case of a 15-year-old girl who presented with abdominal pain. Echocardiography and thoracic computed tomography showed right atrial mass. The patient underwent surgery, chemotherapy, and radiotherapy. Eight months after treatment, abdominal recurrence was detected. The abdominal mass was resected, and radiotherapy and new chemotherapy protocol were given. The present case illustrates a rare case of primary cardiac angiosarcoma posing a diagnostic dilemma in an adolescent girl.

  5. Studies on recurrence of colorectal carcinoma

    Kobayashi, Masayuki; Nosaki, Tadaharu; Murai, Tomoya; Ooshita, Ikuo; Kobayashi, Suzuo

    1989-01-01

    Recurrence patterns of colorectal carcinoma were studied in 402 patients followed up for 5 years or more after surgery. Recurrence was observed in 23% for colon cancer and 38% for rectal canccer. The most frequent site of recurrence or relapse in cases of colon cancer was the liver, followed by multiple organs and a local region; and in the case of rectal cancer, it was multiple organs, followed by a local region, the liver, lung, and bone. The rate of recurrence or relapse tended to be higher in patients with lymph node metastases or more advanced clinical stage. Liver relapse was seen in 13% for colon cancer and 12% for rectal cancer, occurring within 48 months after surgery. Since CT can detect liver relapse within 24 months, abdominal CT and chest plain roentgenography should be performed in the first 6 months, 12 months, and 24 months after surgery. (Namekawa, K)

  6. Iliopsoas compartment lesions: a radiologic evaluation

    Leao, Alberto Ribeiro de Souza; Amaral, Raquel Portugal Guimaraes; Abud, Thiago Giansante; Demarchi, Guilherme Tadeu Sauaia; Freire Filho, Edison de Oliveira; Novack, Paulo Rogerio; Campos, Flavio do Amaral; Shigueoka, David Carlos; Fernandes, Artur da Rocha Correa; Szejnfeld, Jacob; D'Ippolito, Giuseppe

    2007-01-01

    The iliopsoas compartment, a posterior boundary of the retroperitoneum, is comprised of the psoas major, psoas minor and iliac muscles. The symptoms picture in patients presenting with pathological involvement of this compartment may show a wide range of nonspecific clinical presentations that may lead to delayed diagnosis. However, in the search of an etiological diagnosis, it is already known that inflammation, tumors, and hemorrhages account for almost all the lesions affecting the iliopsoas compartment. By means of a retrospective analysis of radiological studies in patients with iliopsoas compartment lesions whose diagnosis was confirmed by anatomopathological evaluation or clinical follow-up, we have reviewed its anatomy as well as the main forms of involvement, with the purpose of identifying radiological signs that may help to narrow down the potential differential diagnoses. As each lesion is approached we will discuss the main radiological findings such as presence of gas in pyogenic abscesses, bone destruction and other bone changes of vertebral bodies in lesions secondary to tuberculosis, involvement of fascial planes in cases of neoplasms, and differences in signal density and intensity of hematomas secondary to hemoglobin degradation, among others. So, we have tried to present cases depicting the most frequent lesions involving the iliopsoas compartment, with emphasis on those signs that can lead us to a more specific etiological diagnosis. (author)

  7. Iliopsoas compartment lesions: a radiologic evaluation

    Leao, Alberto Ribeiro de Souza; Amaral, Raquel Portugal Guimaraes; Abud, Thiago Giansante; Demarchi, Guilherme Tadeu Sauaia; Freire Filho, Edison de Oliveira; Novack, Paulo Rogerio; Campos, Flavio do Amaral; Shigueoka, David Carlos; Fernandes, Artur da Rocha Correa; Szejnfeld, Jacob; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: ar.leao@uol.com.br; Santos, Jose Eduardo Mourao [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)

    2007-07-15

    The iliopsoas compartment, a posterior boundary of the retroperitoneum, is comprised of the psoas major, psoas minor and iliac muscles. The symptoms picture in patients presenting with pathological involvement of this compartment may show a wide range of nonspecific clinical presentations that may lead to delayed diagnosis. However, in the search of an etiological diagnosis, it is already known that inflammation, tumors, and hemorrhages account for almost all the lesions affecting the iliopsoas compartment. By means of a retrospective analysis of radiological studies in patients with iliopsoas compartment lesions whose diagnosis was confirmed by anatomopathological evaluation or clinical follow-up, we have reviewed its anatomy as well as the main forms of involvement, with the purpose of identifying radiological signs that may help to narrow down the potential differential diagnoses. As each lesion is approached we will discuss the main radiological findings such as presence of gas in pyogenic abscesses, bone destruction and other bone changes of vertebral bodies in lesions secondary to tuberculosis, involvement of fascial planes in cases of neoplasms, and differences in signal density and intensity of hematomas secondary to hemoglobin degradation, among others. So, we have tried to present cases depicting the most frequent lesions involving the iliopsoas compartment, with emphasis on those signs that can lead us to a more specific etiological diagnosis. (author)

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

    Tamrin, N S Ahmad; Ibrahim, N

    2014-01-01

    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

  9. [The perichromatin compartment of the cell nucleus].

    Bogoliubov, D S

    2014-01-01

    In this review, the data on the structure and composition of the perichromatin compartment, a special border area between the condensed chromatin and the interchromatin space of the cell nucleus, are discussed in the light of the concept of nuclear functions in complex nuclear architectonics. Morphological features, molecular composition and functions of main extrachromosomal structures of the perichromatin compartment, perichromatin fibrils (PFs) and perichromatin granules (PGs) including nuclear stress-bodies (nSBs) that are derivates of the PGs under heat shock, are presented. A special attention was paid to the features of the molecular compositions of PFs and PGs in different cell types and at different physiological conditions.

  10. Effects of combustible stacking in large compartments

    Gentili, Filippo; Giuliani, Luisa; Bontempi, Franco

    2013-01-01

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

  11. Management of postirradiation recurrent enterocutaneous fistula by muscle flaps

    Lui, R.C.; Friedman, R.; Fleischer, A.

    1989-07-01

    Occasionally surgeons have to operate on patients who have had previous abdominal or pelvic operations and irradiations for malignancies. Bowel resection with primary anastomosis under these circumstances is fraught with major complications such as anastomotic breakdown with intra-abdominal sepsis or recurrent enterocutaneous fistula, which are refractory to conventional management. New techniques for using vascularized muscle flaps from a distant nonirradiated field to achieve safe repair of the bowel defects in three such instances are presented.

  12. Recurrent intussusception, coeliac disease and cholelithiasis: A unique combination

    Sinha C

    2007-01-01

    Full Text Available Authors report an 11-month-old female child, who presented with recurrent episodes of colicky abdominal pain and diarrhea. An abdominal ultrasound revealed small bowel intussusception. She was also noted to have a thick walled gall bladder and a solitary gallstone. Further investigations confirmed the diagnosis of coeliac disease. The combination of small bowel intussusception, coeliac disease and cholelithiasis is unique and has not been reported in the literature.

  13. Abdominal emergencies in pediatrics.

    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. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  14. Abdominal pregnancy - Case presentation.

    Bohiltea, R; Radoi, V; Tufan, C; Horhoianu, I A; Bohiltea, C

    2015-01-01

    Abdominal pregnancy, a rare diagnosis, belongs to the ectopic pregnancy group, the leading cause of pregnancy related exitus. The positive diagnosis is very difficult to establish most often in an acute setting, leading to a staggering percent of feto-maternal morbidity and mortality. We present the case of 26-weeks-old abdominal pregnancy with partial feto-placental detachment in a patient, after hysteroscopy and in vitro fertilization, which until the acute symptoms that led to emergency laparotomy went unrecognized. The patient recovered completely and satisfactorily after surgery and, due to the high risk of uterine rupture with regard to a second pregnancy, opted for a surrogate mother. Abdominal pregnancy can be regarded as a difficult to establish diagnosis, with a greater chance in case of increased awareness. It is compulsory to be well informed in order not to be surprised by the diagnosis and to apply the correct treatment immediately as the morbidity and mortality rate is elevated.

  15. Abdominal paracentesis and thoracocentesis.

    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.

  16. Childhood abdominal cystic lymphangioma

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

    2002-02-01

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

  17. Ultrasonography in abdominal emergencies

    Risi, D.; Alessi, G.; Meli, C.; Marzano, M.; Fiori, E.; Caterino, S.

    1989-01-01

    From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 post-operative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the affidability of ultrasonography in abdominal emergencies, as shown in literature

  18. Childhood abdominal cystic lymphangioma

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra; Dlugy, Elena; Freud, Enrique; Kessler, Ada; Horev, Gadi

    2002-01-01

    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. Conclusions: US

  19. Staged abdominal re-operation for abdominal trauma.

    Taviloglu, Korhan

    2003-07-01

    To review the current developments in staged abdominal re-operation for abdominal trauma. To overview the steps of damage control laparotomy. The ever increasing importance of the resuscitation phase with current intensive care unit (ICU) support techniques should be emphasized. General surgeons should be familiar to staged abdominal re-operation for abdominal trauma and collaborate with ICU teams, interventional radiologists and several other specialties to overcome this entity.

  20. Abdominal Tuberculosis Mimicking Intra-abdominal Malignancy: A ...

    TNHJOURNALPH

    BACKGROUND. Abdominal TB usually presents with nonspecific findings and may thus m.,mw a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

  1. Abdominal tuberculosis mimicking intra-abdominal malignancy: A ...

    Background: Abdominal TB usually presents with nonspecific findings and may thus mimic a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

  2. Leg 201Tl-SPECT in chronic exertional compartment syndrome

    Elkadri, N.; Slim, I.; Blondet, C.; Choquet, Ph.; Constantinesco, A.; Lecocq, J.

    2004-01-01

    Leg 201 Tl-SPECT in chronic exertional compartment syndrome Background: The chronic exertional compartment syndrome is one of the most frequent origins regarding leg pain due to sport training. The diagnosis can be established by invasive compartment pressure measurement. The aim of this study is to evaluate the role that could have 201 Tl-SPECT for patients with suspicion of compartment syndrome. Patients and methods: 51 leg 201 Tl-SPECT exams were performed (exercise - and rest without reinjection) in 49 patients; 28 had compartment syndrome confirmed by pressure measurement. About 100 MBq of 201 Tl were injected during exercise, when pain appeared or at least after 25 minutes exercise. We studied mean percentages of level uptake for each compartment, referred to the maximal uptake of both legs. Results: 47 compartments were concerned by compartment syndrome and 361 compartments were not. Scintigraphic patterns in compartments are reversible ischaemia (45%), uptake stability (36%) or reverse redistribution (19%); these patterns are not linked to compartment syndrome. However, there is a significant difference of rest 201 Tl level uptake between compartments with and without compartment syndrome and a significant correlation between muscular pressure measurement and rest level uptake. Conclusion: 201 Tl-SPECT shows that only ischaemia does not explain compartment syndrome. Moreover, it allows to predict pressure variation during exercise but it does not offer any interest in order to select patients for muscular invasive pressure measurement. (author)

  3. Abdominal and Pelvic CT

    Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...

  4. Functional abdominal pain.

    Grover, Madhusudan; Drossman, Douglas A

    2010-10-01

    Functional abdominal pain syndrome (FAPS) is a relatively less common functional gastrointestinal (GI) disorder defined by the presence of constant or frequently recurring abdominal pain that is not associated with eating, change in bowel habits, or menstrual periods (Drossman Gastroenterology 130:1377-1390, 2006), which points to a more centrally targeted (spinal and supraspinal) basis for the symptoms. However, FAPS is frequently confused with irritable bowel syndrome and other functional GI disorders in which abdominal pain is associated with eating and bowel movements. FAPS also differs from chronic abdominal pain associated with entities such as chronic pancreatitis or chronic inflammatory bowel disease, in which the pain is associated with peripherally acting factors (eg, gut inflammation or injury). Given the central contribution to the pain experience, concomitant psychosocial disturbances are common and strongly influence the clinical expression of FAPS, which also by definition is associated with loss of daily functioning. These factors make it critical to use a biopsychosocial construct to understand and manage FAPS, because gut-directed treatments are usually not successful in managing this condition.

  5. Abdominal and Pelvic CT

    Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and ... abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including but not limited to some liver, kidney, pancreatic, uterine or ... Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  6. Abdominal wall surgery

    ... as liposuction , which is another way to remove fat. But, abdominal wall surgery is sometimes combined with liposuction. ... from the middle and lower sections of your abdomen to make it firmer ... removes excess fat and skin (love handles) from the sides of ...

  7. Abdominal and Pelvic CT

    Full Text Available ... an experienced radiologist can diagnose many causes of abdominal pain or injury from trauma with very high accuracy, ... Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ... Ultrasound - Abdomen X-ray (Radiography) - Lower GI Tract X-ray ( ...

  8. Abdominal Aortic Aneurysm

    ... AAAs don’t cause symptoms unless they leak, tear, or rupture. If this happens, you may experience: sudden pain in your abdomen, groin, back, legs, or buttocks nausea and vomiting abnormal stiffness in your abdominal muscles problems with urination or bowel movements clammy, sweaty ...

  9. Adult abdominal hernias.

    Murphy, Kevin P

    2014-06-01

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

  10. Giant abdominal cystic lymphangioma

    Vazquez, V.; Florencio, I.; Boluda, F.

    1996-01-01

    We present a case of giant abdominal cystic lymphangioma in a 10-year-old boy. Despite numerous consultations with physicians to identify the underlying problem, it had originally been attributed to ascites of unknown cause. We review the characteristics of this lesion and the diagnostic features that aid in differentiating it from ascites

  11. Endometriosis Abdominal wall

    Alvarez, M.; Carriquiry, L.

    2003-01-01

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

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

    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 ...

  13. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... particularly valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type ... help a physician determine the source of abdominal pain, such as gallstones, kidney stones, abscesses or an ...

  14. Intra-abdominal hypertension in acute pancreatitis.

    De Waele, Jan J; Leppäniemi, Ari K

    2009-06-01

    The incidence of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP) is approximately 60-80%. It is usually an early phenomenon, partly related to the effects of the inflammatory process, causing retroperitoneal edema, fluid collections, ascites, and ileus, and partly iatrogenic, resulting from aggressive fluid resuscitation. It also can manifest at a later stage, often associated with local pancreatic complications. IAH is associated with impaired organ dysfunction, especially of the cardiovascular, respiratory, and renal systems. Using current definitions, the incidence of the clinical manifestation, abdominal compartment syndrome (ACS), has been reported as 27% in the largest study so far. Despite several intervention options, the mortality in patients developing ACS remains high: 50-75%. Prevention with judicious use of crystalloids is important, and nonsurgical interventions, such as nasogastric decompression, short-term use of neuromuscular blockers, removal of fluid by extracorporeal techniques, and percutaneous drainage of ascites should be instituted early. The indications for surgical decompression are still not clearly defined, but undoubtedly some patients benefit from it. It can be achieved with full-thickness laparostomy (midline or transverse subcostal) or through a subcutaneous linea alba fasciotomy. Despite the improvement in physiological variables and significant decrease in IAP, the effects of surgical decompression on organ function and outcome are less clear. Because of the significant morbidity associated with surgical decompression and the management of the ensuing open abdomen, more research is needed to define better the appropriate indications and techniques for surgical intervention.

  15. Herpes simplex virus replication compartments can form by coalescence of smaller compartments

    Taylor, Travis J; McNamee, Elizabeth E.; Day, Cheryl; Knipe, David M.

    2003-01-01

    Herpes simplex virus (HSV) uses intranuclear compartmentalization to concentrate the viral and cellular factors required for the progression of the viral life cycle. Processes as varied as viral DNA replication, late gene expression, and capsid assembly take place within discrete structures within the nucleus called replication compartments. Replication compartments are hypothesized to mature from a few distinct structures, called prereplicative sites, that form adjacent to cellular nuclear matrix-associated ND10 sites. During productive infection, the HSV single-stranded DNA-binding protein ICP8 localizes to replication compartments. To further the understanding of replication compartment maturation, we have constructed and characterized a recombinant HSV-1 strain that expresses an ICP8 molecule with green fluorescent protein (GFP) fused to its C terminus. In transfected Vero cells that were infected with HSV, the ICP8-GFP protein localized to prereplicative sites in the presence of the viral DNA synthesis inhibitor phosphonoacetic acid (PAA) or to replication compartments in the absence of PAA. A recombinant HSV-1 strain expressing the ICP8-GFP virus replicated in Vero cells, but the yield was increased by 150-fold in an ICP8-complementing cell line. Using the ICP8-GFP protein as a marker for replication compartments, we show here that these structures start as punctate structures early in infection and grow into large, globular structures that eventually fill the nucleus. Large replication compartments were formed by small structures that either moved through the nucleus to merge with adjacent compartments or remained relatively stationary within the nucleus and grew by accretion and fused with neighboring structures

  16. Effect of Gender on the Total Abdominal Fat, Intra-Abdominal Adipose Tissue and Abdominal Sub-Cutaneous Adipose Tissue among Indian Hypertensive Patients.

    Sahoo, Jaya Prakash; Kumari, Savita; Jain, Sanjay

    2016-04-01

    Abdominal obesity is a better marker of adverse metabolic profile than generalized obesity in hypertensive subjects. Further, gender has effect on adiposity and its distribution. Effect of gender on obesity and the distribution of fat in different sub-compartments of abdomen among Indian hypertensive subjects. This observational study included 278 adult subjects (Males-149 & Females-129) with essential hypertension from a tertiary care centre in north India over one year. A detailed history taking and physical examination including anthropometry were performed in all patients. Total Abdominal Fat (TAF) and abdominal adipose tissue sub-compartments like Intra-Abdominal Adipose Tissue (IAAT) and Sub-Cutaneous Adipose Tissue (SCAT) were measured using the predictive equations developed for Asian Indians. Female hypertensive subjects had higher Body Mass Index (BMI) with more overweight (BMI ≥ 23kg/m(2)), and obesity (BMI≥ 25 kg/m(2)). Additionally, they had higher prevalence of central obesity based on both Waist Circumference (WC) criteria (WC≥ 90 cm in males and WC≥ 80 cm in females) and TAF criteria {≥245.6 cm(2) (males) and ≥203.46 cm(2) (females)} than male patients. But there was no difference in the prevalence of central obesity based on Waist Hip Ratio (WHR) criteria (WHR ≥0.90 in males and WHR ≥ 0.85 in females) between two genders. High TAF & IAAT were present in more females although there was no difference in the distribution of high SCAT between two genders. Female hypertensive subjects were more obese with higher abnormal TAF & IAAT compared to male patients. However, there was no difference in the distribution of high SCAT among them.

  17. DIEP breast reconstruction following multiple abdominal liposuction procedures.

    Farid, Mohammed; Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine

    2014-01-01

    Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Review of case notes and radiological investigations of two patients, and a PubMed search using the terms "DIEP", "deep inferior epigastric", "TRAM", "transverse rectus abdominis", "perforator" and "laparotomy", "abdominal wall", "liposuction", "liposculpture", "fat graft", "pfannenstiel", with subsequent appraisal of relevant papers by the first and second authors. Patient 1 had 3 episodes of liposuction from the abdomen for fat grafting to a reconstructed breast. Subsequent revision reconstruction of the same breast with DIEP flap was preceded by CT angiography, which demonstrated normal perforator anatomy. The reconstruction healed well with no ischaemic complications. Patient 2 had 5 liposuction procedures from the abdomen to graft fat to a wide local excision defect. Recurrence of cancer led to mastectomy and immediate reconstruction with free DIEP flap. Preoperative MR angiography demonstrated a large perforator right of the umbilicus, with which the intraoperative findings were consistent. The patient had an uneventful recovery and good healing with no fat necrosis or wound dehiscence. We demonstrate that DIEP flaps can safely be raised without perfusion-related complications following multiple liposuction procedures to the abdomen. The safe interval between procedures is difficult to quantify, but we demonstrate successful free flap after 16 months.

  18. Multi-compartment Aerosol Transport Model

    Hubbard, Joshua Allen; Santarpia, Joshua; Brotherton, Christopher M.; Omana, Michael Alexis; Rivera, Danielle; Lucero, Gabriel Anthony

    2017-06-01

    A simple aerosol transport model was developed for a multi-compartmented cleanroom. Each compartment was treated as a well-mixed volume with ventilating supply and return air. Gravitational settling, intercompartment transport, and leakage of exterior air into the system were included in the model. A set of first order, coupled, ordinary differential equations was derived from the conservation equations of aerosol mass and air mass. The system of ODEs was then solved in MATLAB using pre-existing numerical methods. The model was verified against cases of (1) constant inlet-duct concentration, and (2) exponentially decaying inlet-duct concentration. Numerical methods resulted in normalized error of less than 10 -9 when model solutions were compared to analytical solutions. The model was validated against experimental measurements from a single field test and showed good agreement in the shape and magnitude of the aerosol concentration profile with time.

  19. A modern definition of mediastinal compartments.

    Carter, Brett W; Tomiyama, Noriyuki; Bhora, Faiz Y; Rosado de Christenson, Melissa L; Nakajima, Jun; Boiselle, Phillip M; Detterbeck, Frank C; Marom, Edith M

    2014-09-01

    Division of the mediastinum into compartments is used to help narrow the differential diagnosis of newly detected mediastinal masses, to assist in planning biopsy and surgical procedures, and to facilitate communication among clinicians of multiple disciplines. Several traditional mediastinal division schemes exist based upon arbitrary landmarks on the lateral chest radiograph. We describe a modern, computed tomography-based mediastinal division scheme, which has been accepted by the International Thymic Malignancy Interest Group as a new standard. This clinical classification defines a prevascular (anterior), a visceral (middle), and a paravertebral (posterior) compartment, with anatomic boundaries defined clearly by computed tomography. It is our intention that this definition be used in the reporting of clinical cases and the design of prospective clinical trials.

  20. Hermetic compartments leak-tightness enhancement

    Murani, J.

    2000-01-01

    In connection with the enhancement of the nuclear safety of the Jaslovske Bohunice V-1 NPP actions for the increase of the leak tightness are performed. The reconstruction has been done in the following directions: hermetic compartments leak tightness enhancement; air lock installation; installation of air lock in SP 4 vent system; integrated leakage rate test to hermetic compartments with leak detection. After 'major' leaks on the hermetic boundary components had been eliminated, since 1994 works on a higher qualitative level began. The essence of the works consists in the detection and identification of leaks in the structural component of the hermetic boundary during the planned refueling outages. The results of the Small Reconstruction and gradual enhancement of leak tightness are presented

  1. Recent advances of CT in the diagnosis of abdominal malignancies

    Itai, Y [Tokyo Univ. (Japan). Faculty of Medicine

    1980-08-01

    Advantages and limitations of CT in the diagnosis of abdominal malignancies are discussed in liver, pancreas, adrenal gland and recurrent tumor. As to hepatocellular carcinoma, main tumors were clearly demonstrated in 83%, equivocally in 9% and negatively in 8%. Rapid injection of contrast material was useful in dividing hepatic masses into hyper- and hypovascular tumors. Sensitivity of pancreatic cancer was high enough, but CT was of limited value in detecting a resectable one. CT was highly effective in diagnosis of adrenal tumors and recurrent tumors.

  2. Monoterpene biosynthesis potential of plant subcellular compartments.

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

    2016-01-01

    Subcellular monoterpene biosynthesis capacity based on local geranyl diphosphate (GDP) availability or locally boosted GDP production was determined for plastids, cytosol and mitochondria. A geraniol synthase (GES) was targeted to plastids, cytosol, or mitochondria. Transient expression in Nicotiana benthamiana indicated local GDP availability for each compartment but resulted in different product levels. A GDP synthase from Picea abies (PaGDPS1) was shown to boost GDP production. PaGDPS1 was also targeted to plastids, cytosol or mitochondria and PaGDPS1 and GES were coexpressed in all possible combinations. Geraniol and geraniol-derived products were analyzed by GC-MS and LC-MS, respectively. GES product levels were highest for plastid-targeted GES, followed by mitochondrial- and then cytosolic-targeted GES. For each compartment local boosting of GDP biosynthesis increased GES product levels. GDP exchange between compartments is not equal: while no GDP is exchanged from the cytosol to the plastids, 100% of GDP in mitochondria can be exchanged to plastids, while only 7% of GDP from plastids is available for mitochondria. This suggests a direct exchange mechanism for GDP between plastids and mitochondria. Cytosolic PaGDPS1 competes with plastidial GES activity, suggesting an effective drain of isopentenyl diphosphate from the plastids to the cytosol. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

  3. Perfluoroalkyl acid distribution in various plant compartments ...

    Crop uptake of perfluoroalkyl acids (PFAAs) from biosolids-amended soil has been identified as a potential pathway for PFAA entry into the terrestrial food chain. This study compared the uptake of PFAAs in greenhouse-grown radish (Raphanus sativus), celery (Apium graveolens var.dulce), tomato (Lycopersicon lycopersicum), and sugar snap pea (Pisum sativum var. macrocarpon) from an industrially impacted biosolids-amended soil, a municipal biosolids­ amended soil, and a control soil. Individual concentrations of PFAAs, on a dry weight basis, in mature, edible portions of crops grown in soil amended with PFAA industrially impacted biosolids were highest for perfluorooctanoate (PFOA; 67 ng/g) in radish root, perfluorobutanoate (PFBA;232 ng/g) in celery shoot, and PFBA (150 ng/g) in pea fruit. Comparatively, PFAA concentrations in edible compartments of crops grown in the municipal biosolids-amended soil and in the control soil were less than 25 ng/g. Bioaccumulation factors (BAFs) were calculated for the root, shoot, and fruit compartments (as applicable) of all crops grown in the industrially impacted soil. BAFs were highest for PFBA in the shoots of all crops, as well as in the fruit compartment of pea. Root­ soil concentration factors (RCFs) for tomato and pea were independent of PFAA chain length, while radish and celery RCFs showed a slight decrease with increasing chain length. Shoot-soil concentration factors (SCFs) for all crops showed a decrease with incre

  4. Salus: Kernel Support for Secure Process Compartments

    Raoul Strackx

    2015-01-01

    Full Text Available Consumer devices are increasingly being used to perform security and privacy critical tasks. The software used to perform these tasks is often vulnerable to attacks, due to bugs in the application itself or in included software libraries. Recent work proposes the isolation of security-sensitive parts of applications into protected modules, each of which can be accessed only through a predefined public interface. But most parts of an application can be considered security-sensitive at some level, and an attacker who is able to gain inapplication level access may be able to abuse services from protected modules. We propose Salus, a Linux kernel modification that provides a novel approach for partitioning processes into isolated compartments sharing the same address space. Salus significantly reduces the impact of insecure interfaces and vulnerable compartments by enabling compartments (1 to restrict the system calls they are allowed to perform, (2 to authenticate their callers and callees and (3 to enforce that they can only be accessed via unforgeable references. We describe the design of Salus, report on a prototype implementation and evaluate it in terms of security and performance. We show that Salus provides a significant security improvement with a low performance overhead, without relying on any non-standard hardware support.

  5. Evaluation of acute compartment syndrome of extremities in ...

    Arun Kumar Agnihotri

    compartment syndrome in children; Acute compartment syndrome and fasciotomy. INTRODUCTIONᴪ .... these patients were manipulated under general anaesthesia ... of these children. The clinical diagnosis of increased ICP is not easy.

  6. Compartment syndrome can also be seen in the forearm

    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...

  7. 14 CFR 23.853 - Passenger and crew compartment interiors.

    2010-01-01

    ... Photographic Film PH1.25 (available from the American National Standards Institute, 1430 Broadway, New York, N... stowage compartments and compartments for stowing small items such as magazines and maps) must be self...

  8. Mesothelioma as a rapidly developing Giant Abdominal Cyst

    Vyas Dinesh

    2012-12-01

    Full Text Available Abstract The benign cystic mesothelioma of the peritoneum is a rare lesion and is known for local recurrence. This is first case report of a rapidly developing massive abdominal tumor with histological finding of benign cystic mesothelioma (BCM. We describe a BCM arising in the retroperitoneal tis[sue on the right side, lifting ascending colon and cecum to the left side of abdomen. Patient was an active 58-year-old man who noticed a rapid abdominal swelling within a two month time period with a weight gain of 40 pounds. Patient had no risk factors including occupational (asbestos, cadmium, family history, social (alcohol, smoking or history of trauma. We will discuss the clinical, radiologic, intra-operative, immunohistochemical, pathologic findings, and imaging six months after surgery. Patient has no recurrence and no weight gain on follow up visits and imaging.

  9. Abdominal Pain-Predominant Functional Gastrointestinal Disorders in Jordanian School Children.

    Altamimi, Eyad M; Al-Safadi, Mohammad H

    2014-12-01

    Recurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children. This is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabic translation - was collected. Classes from academic years (grades) 6 - 8 were selected. SPSS Statistical Package Version 17 (IBM, Armonk, NY, USA) was used. Categorical data were analyzed using Fisher's exact test, and continuous data were analyzed using t -test. P abdominal pain-predominant FGID. Seventy-nine (68%) of them were females. Forty-seven (10.6%) had irritable bowel syndrome (IBS). Thirty-six (8%), 17 (3.8%), 11 (2.4%) and five (1.1%) had abdominal migraine, functional abdominal pain, functional abdominal pain syndrome and functional dyspepsia, respectively. Abdominal pain-predominant FGID has become a major health issue in Jordanian children. One of four children between the ages of 11 and 15 years exhibits at least one abdominal pain-predominant FGID. The most common form of abdominal pain-predominant FGID in our children was IBS. Females are affected more often than males. Intestinal and extra-intestinal symptoms are seen regularly with abdominal pain-predominant FGIDs.

  10. Role of laparoscopy in evaluation of abdominal pain

    Masud, M.; Adil, M.; Gondal, Z.I.; Aquil, A.

    2017-01-01

    Objective: To evaluate the diagnostic efficacy of laparoscopy in ill-defined recurrent chronic abdominal pain. Study Design: Prospective study. Place and Duration of Study: Surgical department, Military Hospital Rawalpindi, from Jul 2011 to Dec 2013. Material and Methods: A total of 102 patients who presented to surgical department with chronic recurrent abdominal pain of unknown etiology and underwent diagnostic laparoscopy were included in our study. Patients with acute onset of abdominal pain, hemodynamically unstable, pregnant or those in which diagnosis can be made by radiological techniques were excluded from our study. Patient's demographic data, clinical findings and laparoscopic findings were recorded. Finally data was analyzed by using SPSS version 21. Results: Out of 110 patients 96 were female while remaining 14 were male. The age range of the patients was 20- 70 years with mean age of 50 +- 10 years. The most common site of pain was lower abdomen while mean duration of abdominal pain was 34 weeks. Laparoscopic findings include acute recurrent appendicitis in 32 (29.09%) patients, cholecystitis with biliary sludge in 14 (12.72%), pelvic inflammatory disease in 12 (10.90%), ovarian cyst in 11(10%), adhesions in 10(9.09%), intestinal tuberculosis in 8 (7.27%), mesenteric lymphadenitis in 7 (6.36%), lymphoma in 4 (3.63%), ectopic pregnancy in 3 (2.7%), CA gallbladder in 2 (1.81%), meckels diverticulum in 2 (1.81%), endometriosis in 2 (1.81%) and crohns disease in 1 (0.9%) patients. Mean operative time was 48 min while average hospital stay was 2-3 days. No major complications were noticed. Conclusion: Laparoscopy in our clinical setup has significant role in diagnosing cases of vague abdominal pain which cannot be diagnosed by routine investigations. (author)

  11. ABDOMINAL TRAUMA- CLINICAL STUDY

    Vanaja Ratnakumari Billa

    2017-08-01

    Full Text Available BACKGROUND In the recent times there has been increased incidence of abdominal trauma cases due to several causes. Quick and prompt intervention is needed to decrease the mortality of the patients. So we conducted a study to assess the cause and the management of abdominal trauma cases in our institution. The aim of this study was to know the incidence of blunt and penetrating injuries and their causes, age and sex incidence, importance of various investigations, mode of treatment offered and post-operative complications. To study the cause of death and evolve better management. MATERIALS AND METHODS The present study comprises of patients admitted to and operated in various surgical units in the Department of Surgery at Government General Hospital, attached to Guntur Medical College Guntur, from August 2014 to October 2016. RESULTS Increase incidence seen in age group 20-29 years (30%. Male predominance 77.5%. Mechanism of injury–road traffic accidents 65%. Isolated organ injury–colon and rectum 40%. Other associated injuries–chest injuries with rib fractures 7.5%. Complications–wound infection 17.5%. Duration of hospital stay 8–14 days. Bowel injury management–closure of perforation 84.6%. Resection anastomosis 15.38%. CONCLUSION Thorough clinical examination, diagnostic paracentesis, plain X-ray erect abdomen and ultrasound proved to be very helpful in the diagnosis of intra-abdominal injuries. Spleen is the commonest organ involved in blunt trauma and colon is the commonly injured organ in penetrating abdominal trauma, many patients have associated extremity and axial skeleton injuries. With advances in diagnosis and intensive care technologies, most patients of solid visceral injuries with hemodynamic stability can be managed conservatively. Surgical site infection is the most common complication following surgery. The mortality is high; reason might be patient reaching the hospital late, high incidence of postoperative septic

  12. CT of abdominal tumor

    Endo, Satoshi; Yamada, Kenji; Ito, Masatoshi; Ito, Hisao; Yamaura, Harutsugu

    1981-01-01

    CT findings in 33 patients who had an abdominal tumor were evaluated. CT revealed a tumor in 31 cases. The organ from which the tumor originated was correctly diagnosed in 18 patients. Whether the tumor was solid or cystic was correctly predicted in 28 patients. The diagnosis malignant or benign nature of tumor was correct, incorrect and impossible, in 23, 3, and five patiens, respectively. (Kondo, M.)

  13. Detoxification in Abdominal Sepsis

    A. F. Potapov

    2005-01-01

    Full Text Available Objective. To comparatively analyze the efficiency of methods for extracorporeal detoxification (ED of the body in abdominal sepsis (AS and to choose the optimum detoxifying methods in relation to the level of endotoxicosis.Material and methods. 56 patients (41 males and 15 females; mean age 39.4±12.2 years with surgical abdominal infection of various genesis, complicated by the development of sepsis whose treatment included ED methods, were examined. The level of intoxication and the efficiency of detoxification were evaluated by general clinical and biochemical blood parameters, the leukocytic intoxication index, the levels of low and medium molecular-weight substances in the body’s media. Hemosorption, plasmapheresis, hemodialysis, hemodiafiltration, and hemofiltration were used for detoxification.Results. Surgical abdominal infection is accompanied by endotoxemia that has no clear nosological specificity, but it depends on the pattern of a clinical course of the disease and is most pronounced in the septic syndrome. In AS, 80.4% of the patients are observed to have an irreversible decompensation phase and a terminal degree of endotoxicosis, which require detoxification. The use of different ED methods according to the level of intoxication may reduce the level of endotoxicosis and yield a persistent beneficial effect in 85.2% of cases of its application. Conclusion. Filtration and dialysis techniques (hemodialysis, hemofiltration, and hemodiafiltration are the methods of choice in AS. Hemosorption and plasmapheresis may be recommended for use at the early stages of endotoxicosis development and in preserved renal excretory function.

  14. Abdominal aspergillosis: CT findings

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

    2011-03-15

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

  15. 46 CFR 169.627 - Compartments containing diesel fuel tanks.

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Compartments containing diesel fuel tanks. 169.627... SCHOOL VESSELS Machinery and Electrical Ventilation § 169.627 Compartments containing diesel fuel tanks. Unless they are adequately ventilated, enclosed compartments or spaces containing diesel fuel tanks and...

  16. Abdominal Pain-Predominant Functional Gastrointestinal Disorders in Jordanian School Children

    Altamimi, Eyad M.; Al-Safadi, Mohammad H.

    2014-01-01

    Background Recurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children. Methods This is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabi...

  17. Intestinal fatty acid binding protein as a marker for intra-abdominal pressure-related complications in patients admitted to the intensive care unit; study protocol for a prospective cohort study (I-Fabulous study)

    K.D. Strang; O.J.F. van Waes (Oscar); B. van der Hoven (Ben); S. Ali (Samir); M.H.J. Verhofstad (Michiel); P. Pickkers (Peter); E.M.M. van Lieshout (Esther)

    2015-01-01

    textabstractBackground: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with increased morbidity and mortality in critically ill patients admitted to an intensive care unit. Intra-bladder measurement of the

  18. Intestinal fatty acid binding protein as a marker for intra-abdominal pressure-related complications in patients admitted to the intensive care unit; study protocol for a prospective cohort study (I-Fabulous study)

    Strang, S.G.; Waes, O.J. van; Hoven, B. van der; Ali, S.; Verhofstad, M.H.J.; Pickkers, P.; Lieshout, E.M. van

    2015-01-01

    BACKGROUND: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with increased morbidity and mortality in critically ill patients admitted to an intensive care unit. Intra-bladder measurement of the

  19. An abdominal tuberculosis case mimicking an abdominal mass

    An abdominal tuberculosis case mimicking an abdominal mass. Derya Erdog˘ an a. , Yasemin Ta ¸scı Yıldız b. , Esin Cengiz Bodurog˘lu c and Naciye Go¨nu¨l Tanır d. Abdominal tuberculosis is rare in childhood. It may be difficult to diagnose as it mimics various disorders. We present a 12-year-old child with an unusual ...

  20. A Case of Pediatric Abdominal Wall Reconstruction: Components Separation within the Austere War Environment

    Ian Valerio, MD, MS, MBA, FACS

    2014-07-01

    Full Text Available Summary: Reconstructive surgeons supporting military operations are required to definitively treat severe pediatric abdominal injuries in austere environments. The safety and efficacy of using a components separation technique to treat large ventral hernias in pediatric patients in this setting remains understudied. Components separation technique was required to achieve definitive closure in a 12-month-old pediatric patient in Kandahar, Afghanistan. Her course was complicated by an anastomotic leak after small bowel resection. Her abdominal was successfully reopened, the leak repaired, and closed primarily without incident on postinjury day 9. Abdominal trauma with a large ventral hernia requiring components separation is extremely rare. A pediatric patient treated with components separation demonstrated minimal complications, avoidance of abdominal compartment syndrome, and no mortality.

  1. Multi-compartment linear noise approximation

    Challenger, Joseph D; McKane, Alan J; Pahle, Jürgen

    2012-01-01

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

  2. In need of a patch UP: Recurrent congenital diaphragmatic hernia presenting with a large pleural effusion

    Farhana Shariff

    2014-10-01

    Full Text Available We report a case of recurrent congenital diaphragmatic hernia (CDH presenting with a large unilateral pleural effusion. A 12-year old boy who had a left sided CDH repaired in the neonatal period, presented with fever, lethargy, and non-productive cough. Chest radiograph demonstrated a loculated pleural effusion. Computed tomography scan revealed recurrent herniation of abdominal contents. To our knowledge, this is the first reported case of a recurrent congenital diaphragmatic hernia presenting with large pleural effusion.

  3. [Differential diagnosis of abdominal pain].

    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.

  4. Abdominal wall blocks in adults

    Børglum, Jens; Gögenür, Ismail; Bendtsen, Thomas F

    2016-01-01

    been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery.  Summary USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned......Purpose of review Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research.......  Recent findings Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall...

  5. Abdominal imaging: An introduction

    Frick, M.P.; Feinberg, S.B.

    1986-01-01

    This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures

  6. Abdominal Aortic Emergencies.

    Lech, Christie; Swaminathan, Anand

    2017-11-01

    This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. CT findings in recurrent pyogenic cholangitis

    Jung, Seung Hye; Lim, Jae Hoon; Ko, Young Tae; Lee, Dong Ho

    1991-01-01

    Recurrent pyogenic cholangitis is characterized clinically by recurrent attacks of right upper abdominal pain, fever and jaundice, and pathologically by chronic inflammation of the bile ducts with or without pigment bile duct stones. We analyzed the CT findings of 33 cases with recurrent pyogenic cholangitis. Twenty-four cases were confirmed by operation, and 9 cases were diagnosed clinically and cholangiographically. The CT findings of recurrent pyogenic cholangitis were dilatation of the intrahepatic ducts (n = 30), dilatation of the extrahepatic ducts (n = 24) intrahepatic stones (n = 16), extrahepatic stones (n = 12), stricture of the bile ducts (n = 10), wall enhancement of the bile ducts (n = 8), gallstones (n = 8), segmental atrophy of the liver (n = 7), pneumobilia (n = 4), abscess (n = 3), and segmental enhancement (n = 1) of the liver. A CT is considered helpful when sectional imaging is needed, but sonographic findings are equivocal or not confirmative; space-occupying lesions complicated with recurrent pyogenic cholangitis: hepatic resection is planned; and imaging guidance is needed for complex drainage procedures

  8. Evaluation of mesenteric lymph nodes in children with abdominal pain

    Jedrzejewski, G.

    2008-01-01

    The aim of this study was to evaluate the prevalence of enlarged mesenteric lymph nodes seen on pediatric abdominal ultrasound examinations performed in children with abdominal pain. Ultrasound was performed with Sonoline Elegra and Philips iU-22 units with convex-array 2-5 MHz transducer for the general abdominal examination, and in addition with convex 5-8 MHz or linear 7.5 MHz transducers specially to detect lymph nodes. Enlarged lymph nodes were found in 248 (21,2%) out of 1171 symptomatic patients. In 53 patients some other abnormalities were found. The nodes were mostly disc-like and oval in shape. They had usually a homogeneous appearance and were iso- or hypoechoic relative to the surrounding tissues and intestinal loops. Mesenteric lymphadenitis is commonly reported in children with acute, chronic or recurrent abdominal pain and no evidence of other pathologies, and has been reported as one of the most common explanation for acute right lower quadrant abdominal pain. (authors)

  9. Chronic abdominal wall pain misdiagnosed as functional abdominal pain.

    van Assen, Tijmen; de Jager-Kievit, Jenneke W A J; Scheltinga, Marc R; Roumen, Rudi M H

    2013-01-01

    The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. In this cross-sectional analysis, 4 Dutch primary care practices employing physicians who were unaware of the existence of ACNES were selected. A total of 535 patients ≥18 years old who were registered with a functional abdominal pain diagnosis were approached when they were symptomatic to complete the questionnaire (maximum 18 points). Responders who scored at least the 10-point cutoff value (sensitivity, 0.94; specificity, 0.92) underwent a diagnostic evaluation to establish their final diagnosis. The main outcome was the presence and prevalence of ACNES in a group of symptomatic patients diagnosed with functional abdominal pain. Of 535 patients, 304 (57%) responded; 167 subjects (31%) recently reporting symptoms completed the questionnaire. Of 23 patients who scored above the 10-point cutoff value, 18 were available for a diagnostic evaluation. In half of these subjects (n = 9) functional abdominal pain (including IBS) was confirmed. However, the other 9 patients were suffering from abdominal wall pain syndrome, 6 of whom were diagnosed with ACNES (3.6% prevalence rate of symptomatic subjects; 95% confidence interval, 1.7-7.6), whereas the remaining 3 harbored a painful lipoma, an abdominal herniation, and a painful scar. A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES.

  10. A case of Behcet's disease with aneurysms of common carotid arteries and abdominal aorta

    Choo, Yeon Myung; Chang, Kee Hyun; Choi, Sung Jae

    1984-01-01

    One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddenly developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated multiple aneurysms in both common carotid arteries and abdominal aorta with organizing thrombi and thromboembolism of internal carotid artery

  11. Children's (Pediatric) Abdominal Ultrasound Imaging

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

  12. Laparoscopic management of abdominal cocoon

    Makam Ramesh

    2008-01-01

    Full Text Available "Peritonitis fibrosa incapsulata", first described in 1907, is a condition characterized by encasement of the bowel with a thick fibrous membrane. This condition was renamed as "abdominal cocoon" in 1978. It presents as small bowel obstruction clinically. 35 cases of abdominal cocoon have been reported in the literature over the last three decades. Abdominal cocoon is more common in adolescent girls from tropical countries. Various etiologies have been described, including tubercular. It is treated surgically by releasing the entrapped bowel. We report a laparoscopic experience of tubercular abdominal cocoon and review the literature.

  13. Abdominal muscle function and incisional hernia

    Jensen, K K; Kjaer, M; Jorgensen, L N

    2014-01-01

    PURPOSE: Although ventral incisional hernia (VIH) repair in patients is often evaluated in terms of hernia recurrence rate and health-related quality of life, there is no clear consensus regarding optimal operative treatment based on these parameters. It was proposed that health-related quality...... of life depends largely on abdominal muscle function (AMF), and the present review thus evaluates to what extent AMF is influenced by VIH and surgical repair. METHODS: The PubMed and EMBASE databases were searched for articles following a systematic strategy for inclusion. RESULTS: A total of seven...... studies described AMF in relation to VIH. Five studies examined AMF using objective isokinetic dynamometers to determine muscle strength, and two studies examined AMF by clinical examination-based muscle tests. CONCLUSION: Both equipment-related and functional muscle tests exist for use in patients...

  14. Altered trunk muscle recruitment patterns during lifting in individuals in remission from recurrent low back pain.

    Suehiro, Tadanobu; Ishida, Hiroshi; Kobara, Kenichi; Osaka, Hiroshi; Watanabe, Susumu

    2018-04-01

    Changes in the recruitment pattern of trunk muscles may contribute to the development of recurrent or chronic symptoms in people with low back pain (LBP). However, the recruitment pattern of trunk muscles during lifting tasks associated with a high risk of LBP has not been clearly determined in recurrent LBP. The present study aimed to investigate potential differences in trunk muscles recruitment patterns between individuals with recurrent LBP and asymptomatic individuals during lifting. The subjects were 25 individuals with recurrent LBP and 20 asymptomatic individuals. Electromyography (EMG) was used to measure onset time, EMG amplitude, overall activity of abdominal muscles, and overall activity of back muscles during a lifting task. The onsets of the transversus abdominis/internal abdominal oblique and multifidus were delayed in the recurrent LBP group despite remission from symptoms. Additionally, the EMG amplitudes of the erector spinae, as well as the overall activity of abdominal muscles or back muscles, were greater in the recurrent LBP group. No differences in EMG amplitude of the external oblique, transversus abdominis/internal abdominal oblique, and multifidus were found between the groups. Our findings indicate the presence of an altered trunk muscle recruitment pattern in individuals with recurrent LBP during lifting. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Recurrent Intracerebral Hemorrhage

    Schmidt, Linnea Boegeskov; Goertz, Sanne; Wohlfahrt, Jan

    2016-01-01

    BACKGROUND: Intracerebral hemorrhage (ICH) is a disease with high mortality and a substantial risk of recurrence. However, the recurrence risk is poorly documented and the knowledge of potential predictors for recurrence among co-morbidities and medicine with antithrombotic effect is limited....... OBJECTIVES: 1) To estimate the short- and long-term cumulative risks of recurrent intracerebral hemorrhage (ICH). 2) To investigate associations between typical comorbid diseases, surgical treatment, use of medicine with antithrombotic effects, including antithrombotic treatment (ATT), selective serotonin...

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

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

    2002-09-01

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

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

    Marincek, B.

    2002-01-01

    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.)

  18. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon

    Legakis Nikolaos

    2006-02-01

    Full Text Available Abstract Background Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon is a rare cause of small bowel obstruction, especially in adult population. Diagnosis is usually incidental at laparotomy. We discuss one such rare case, outlining the fact that an intra-operative surprise diagnosis could have been facilitated by previous investigations. Case presentation A 56 year-old man presented in A&E department with small bowel ileus. He had a history of 6 similar episodes of small bowel obstruction in the past 4 years, which resolved with conservative treatment. Pre-operative work-up did not reveal any specific etiology. At laparotomy, a fibrous capsule was revealed, in which small bowel loops were encased, with the presence of interloop adhesions. A diagnosis of abdominal cocoon was established and extensive adhesiolysis was performed. The patient had an uneventful recovery and follow-up. Conclusion Idiopathic sclerosing encapsulating peritonitis, although rare, may be the cause of a common surgical emergency such as small bowel ileus, especially in cases with attacks of non-strangulating obstruction in the same individual. A high index of clinical suspicion may be generated by the recurrent character of small bowel ileus combined with relevant imaging findings and lack of other plausible etiologies. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a "surprise" upon laparotomy and result in proper management.

  19. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon).

    Serafimidis, Costas; Katsarolis, Ioannis; Vernadakis, Spyros; Rallis, George; Giannopoulos, George; Legakis, Nikolaos; Peros, George

    2006-02-13

    Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon) is a rare cause of small bowel obstruction, especially in adult population. Diagnosis is usually incidental at laparotomy. We discuss one such rare case, outlining the fact that an intra-operative surprise diagnosis could have been facilitated by previous investigations. A 56 year-old man presented in A&E department with small bowel ileus. He had a history of 6 similar episodes of small bowel obstruction in the past 4 years, which resolved with conservative treatment. Pre-operative work-up did not reveal any specific etiology. At laparotomy, a fibrous capsule was revealed, in which small bowel loops were encased, with the presence of interloop adhesions. A diagnosis of abdominal cocoon was established and extensive adhesiolysis was performed. The patient had an uneventful recovery and follow-up. Idiopathic sclerosing encapsulating peritonitis, although rare, may be the cause of a common surgical emergency such as small bowel ileus, especially in cases with attacks of non-strangulating obstruction in the same individual. A high index of clinical suspicion may be generated by the recurrent character of small bowel ileus combined with relevant imaging findings and lack of other plausible etiologies. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a "surprise" upon laparotomy and result in proper management.

  20. Abdominal Wall Metastasis from an Invasive Lobular Carcinoma of the Breast: A Case Report

    Kim, Hana; Son, Eun Ju; Youk, Ji Hyun; Chung, Jin [Dept. of Radiology, Gangnam Severance Hospital, Yensei University College of Medicine, Seoul (Korea, Republic of); Noh, Song Mi; Jung, Woo Hee [Dept. of Diagnostic Pathology, Gangnam Severance Hospital, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    Breast cancer is one of the most common malignancies in women. Breast cancer frequently metastasizes to the bones, lungs, and liver. However, the recurrence of distant soft-tissue metastasis except to the chest wall is extremely rare. Here, we describe our experience with a patient in whom invasive lobular carcinoma of the breast with metastasis to the abdominal wall presented as subcutaneous nodules without local recurrence.

  1. Abdominal Wall Metastasis from an Invasive Lobular Carcinoma of the Breast: A Case Report

    Kim, Hana; Son, Eun Ju; Youk, Ji Hyun; Chung, Jin; Noh, Song Mi; Jung, Woo Hee

    2011-01-01

    Breast cancer is one of the most common malignancies in women. Breast cancer frequently metastasizes to the bones, lungs, and liver. However, the recurrence of distant soft-tissue metastasis except to the chest wall is extremely rare. Here, we describe our experience with a patient in whom invasive lobular carcinoma of the breast with metastasis to the abdominal wall presented as subcutaneous nodules without local recurrence.

  2. Effects of abdominal pressure on venous return: abdominal vascular zone conditions.

    Takata, M; Wise, R A; Robotham, J L

    1990-12-01

    The effects of changes in abdominal pressure (Pab) on inferior vena cava (IVC) venous return were analyzed using a model of the IVC circulation based on a concept of abdominal vascular zone conditions analogous to pulmonary vascular zone conditions. We hypothesized that an increase in Pab would increase IVC venous return when the IVC pressure at the level of the diaphragm (Pivc) exceeds the sum of Pab and the critical closing transmural pressure (Pc), i.e., zone 3 conditions, but reduce IVC venous return when Pivc is below the sum of Pab and Pc, i.e., zone 2 conditions. The validity of the model was tested in 12 canine experiments with an open-chest IVC bypass. An increase in Pab produced by phrenic stimulation increased the IVC venous return when Pivc-Pab was positive but decreased the IVC venous return when Pivc - Pab was negative. The value of Pivc - Pab that separated net increases from decreases in venous return was 1.00 +/- 0.72 (SE) mmHg (n = 6). An increase in Pivc did not influence the femoral venous pressure when Pivc was lower than the sum of Pab and a constant, 0.96 +/- 0.70 mmHg (n = 6), consistent with presence of a waterfall. These results agreed closely with the predictions of the model and its computer simulation. The abdominal venous compartment appears to function with changes in Pab either as a capacitor in zone 3 conditions or as a collapsible Starling resistor with little wall tone in zone 2 conditions.

  3. Modified sandwich vacuum pack technique for temporary closure of abdominal wounds: an African perspective.

    van As, A B; Navsaria, P; Numanoglu, A; McCulloch, M

    2007-01-01

    South Africa has very high levels of accidental trauma as well as interpersonal violence. There are more admissions for trauma in South Africa than for any other disease; therefore it can be regarded as the Number 1 disease in the country. Complex abdominal injuries are common, requiring specific management techniques. The aim is to document our experience with the Modified Sandwich Vacuum Pack technique for temporary closure of abdominal wounds. After providing a short historical overview, we will demonstrate the technique which we carefully adapted over the last decade to the present Modified Sandwich Vacuum Pack technique. In the Last 5 years we utilized our Modified Sandwich Vacuum Pack technique 153 times in 69 patients. Five (5) patients were under the age of 12 years. In the patient group over 12 years the most common indication for using our technique were penetrating injuries (40), abdominal sepsis (28), visceral edema (10), abdominal compartment syndrome (9), abdominal packs (6),Abdominal wall defects (2). In the group under 12-years the 2 children had liver ruptures (posttraumatic) and 3 liver transplantations. The average cost for the materials used with our technique was ZAR 96. (10 Euro and 41 cents). In our experience the Modified Sandwich Vacuum Pack technique is an effective, cheap methodology to deal with open abdomens in the African setting.A drawback may be the technical expertise required, particular in centers dealing with low numbers of complex abdominal trauma.

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

    Qian Huang

    2016-01-01

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

  5. Modeling malware propagation using a carrier compartment

    Hernández Guillén, J. D.; Martín del Rey, A.

    2018-03-01

    The great majority of mathematical models proposed to simulate malware spreading are based on systems of ordinary differential equations. These are compartmental models where the devices are classified according to some types: susceptible, exposed, infectious, recovered, etc. As far as we know, there is not any model considering the special class of carrier devices. This type is constituted by the devices whose operative systems is not targeted by the malware (for example, iOS devices for Android malware). In this work a novel mathematical model considering this new compartment is considered. Its qualitative study is presented and a detailed analysis of the efficient control measures is shown by studying the basic reproductive number.

  6. The upper hand on compartment syndrome.

    Dolan, Roisin T

    2012-11-01

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

  7. An experimental study on crib fires in a closed compartment

    Dhurandher Bhisham Kumar

    2017-01-01

    Full Text Available An experimental investigation on burning behavior of fire in closed compartments is presented. Fire experiments were performed in a closed compartment of interior dimensions 4 × 4 × 4 m (length × width × height with ply board cribs as fire source. The parameters including the gas temperature, mass loss rate, heat flux, flame temperature, and compartment pressure were measured during the experiments. Experimental results indicated that the providing sudden ventilation to the closed compartment had great influence on the behavior of fire. The mass loss rate of the burning crib increased by 150% due to sudden ventilation which results in the increase in heat release rate by 198 kW. From the perspective of total heat flux, compartment pressure, and gas temperatures closed compartment with sudden ventilation were more hazardous.

  8. Abdominal aortic aneurysms

    Lindholt, Jes S.

    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...... surgery of symptomfree AAA. In order to fulfil all WHO, European, and Danish criteria for screening, a randomised hospitalbased screening trial of 12,639 65-73 year old men in Viborg County (Denmark) was initiated in 1994. It seemed that US screening is a valid, suitable and acceptable method of screening...... patients without previous hospital discharge diagnoses due to cardiovascular disease than among similar men without AAA. The absolute risk difference after 5 years was 16%. So, they will benefit from general cardiovascular preventive action as smoking cessation, statins and low-dose aspirin, which could...

  9. Abdominal Burkitt lymphoma

    Alvarez, Romina J.; Villavicencio, Roberto L.; Oxilia, Hector G.

    2004-01-01

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

  10. Functional abdominal pain syndrome.

    Clouse, Ray E; Mayer, Emeran A; Aziz, Qasim; Drossman, Douglas A; Dumitrascu, Dan L; Mönnikes, Hubert; Naliboff, Bruce D

    2006-04-01

    Functional abdominal pain syndrome (FAPS) differs from the other functional bowel disorders; it is less common, symptoms largely are unrelated to food intake and defecation, and it has higher comorbidity with psychiatric disorders. The etiology and pathophysiology are incompletely understood. Because FAPS likely represents a heterogeneous group of disorders, peripheral neuropathic pain mechanisms, alterations in endogenous pain modulation systems, or both may be involved in any one patient. The diagnosis of FAPS is made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required. Management is based on a therapeutic physician-patient relationship and empirical treatment algorithms using various classes of centrally acting drugs, including antidepressants and anticonvulsants. The choice, dose, and combination of drugs are influenced by psychiatric comorbidities. Psychological treatment options include psychotherapy, relaxation techniques, and hypnosis. Refractory FAPS patients may benefit from a multidisciplinary pain clinic approach.

  11. Abdominal aortic aneurysm surgery

    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...... patients, 51 (9%) of whom died within the first 48 hours. Of the 502 patients who survived for more than 48 hours, 109 required ICU therapy for more than 48 hours, whereas 393 patients were in the ICU for less than 48 hours. The incidence of preoperative risk factors was similar for the two groups...... combined failed to permit identification of patients in whom the perioperative survival rate was 0%. Even 20% of patients with multiorgan failure survived for 6 months. Of those patients who needed ICU therapy for more than 48 hours, 41 (38%) were alive at the end of 1988. In response to a questionnaire...

  12. Abdominal epilepsy in a Nigerian child S

    Abdominal epilepsy is an exceptionally rare cause of abdominal pain that is more likely to ... We report on a child with episodic paroxysmal abdominal pain, accompanied by ... causes for the presenting complaints, work-up should proceed.

  13. A human cadaver fascial compartment pressure measurement model.

    Messina, Frank C; Cooper, Dylan; Huffman, Gretchen; Bartkus, Edward; Wilbur, Lee

    2013-10-01

    Fresh human cadavers provide an effective model for procedural training. Currently, there are no realistic models to teach fascial compartment pressure measurement. We created a human cadaver fascial compartment pressure measurement model and studied its feasibility with a pre-post design. Three faculty members, following instructions from a common procedure textbook, used a standard handheld intra-compartment pressure monitor (Stryker(®), Kalamazoo, MI) to measure baseline pressures ("unembalmed") in the anterior, lateral, deep posterior, and superficial posterior compartments of the lower legs of a fresh human cadaver. The right femoral artery was then identified by superficial dissection, cannulated distally towards the lower leg, and connected to a standard embalming machine. After a 5-min infusion, the same three faculty members re-measured pressures ("embalmed") of the same compartments on the cannulated right leg. Unembalmed and embalmed readings for each compartment, and baseline readings for each leg, were compared using a two-sided paired t-test. The mean baseline compartment pressures did not differ between the right and left legs. Using the embalming machine, compartment pressure readings increased significantly over baseline for three of four fascial compartments; all in mm Hg (±SD): anterior from 40 (±9) to 143 (±44) (p = 0.08); lateral from 22 (±2.5) to 160 (±4.3) (p cadaver using a standard embalming machine. Set-up is minimal and the model can be incorporated into teaching curricula. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. VACUUM THERAPY VERSUS ABDOMINAL EXERCISES ON ABDOMINAL OBESITY

    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.

  15. Removal of an intra-abdominal desmoplastic small round cell tumor by repetitive debulking surgery: A case report and literature review

    SHIMAZAKI, JIRO; MOTOHASHI, GYO; NISHIDA, KIYOTAKA; TABUCHI, TAKANOBU; UBUKATA, HIDEYUKI; TABUCHI, TAKAFUMI

    2014-01-01

    In the current study, a case of recurrent desmoplastic small round cell tumor (DSRCT) is presented, which was successfully treated by repetitive debulking surgery. In May 2010, a 39-year-old male, with a history of surgical resection of intra-abdominal DSRCT, visited the Ibaraki Medical Center, Tokyo Medical University Hospital (Ami, Japan) with severe lower abdominal discomfort. Abdominal computed tomography revealed a large tumor in the pouch of Douglas with a small number of nodules in the...

  16. Surgical resection of late solitary locoregional gastric cancer recurrence in stomach bed.

    Watanabe, Masanori; Suzuki, Hideyuki; Maejima, Kentaro; Komine, Osamu; Mizutani, Satoshi; Yoshino, Masanori; Bo, Hideki; Kitayama, Yasuhiko; Uchida, Eiji

    2012-07-01

    Late-onset and solitary recurrence of gastric signet ring cell (SRC) carcinoma is rare. We report a successful surgical resection of late solitary locoregional recurrence after curative gastrectomy for gastric SRC carcinoma. The patient underwent total gastrectomy for advanced gastric carcinoma at age 52. Seven years after the primary operation, he visited us again with sudden onset of abdominal pain and vomiting. We finally decided to perform an operation, based on a diagnosis of colon obstruction due to the recurrence of gastric cancer by clinical findings and instrumental examinations. The laparotomic intra-abdominal findings showed that the recurrent tumor existed in the region surrounded by the left diaphragm, colon of splenic flexure, and pancreas tail. There was no evidence of peritoneal dissemination, and peritoneal lavage fluid cytology was negative. We performed complete resection of the recurrent tumor with partial colectomy, distal pancreatectomy, and partial diaphragmectomy. Histological examination of the resected specimen revealed SRC carcinoma, identical in appearance to the previously resected gastric cancer. We confirmed that the intra-abdominal tumor was a locoregional gastric cancer recurrence in the stomach bed. The patient showed a long-term survival of 27 months after the second operation. In the absence of effective alternative treatment for recurrent gastric carcinoma, surgical options should be pursued, especially for late and solitary recurrence.

  17. Lower abdominal wall reconstructions with pedicled rectus femoris flaps

    Arashiro, Ken; Nishizeki, Osamu; Ishida, Kunihiro

    2003-01-01

    During the past 10 years, seven pedicled rectus femoris muscle or musculocutaneous flaps were used to repair lower abdominal defects; three recalcitrant incisional hernias with previous radiotherapy, two long-standing wound infections after synthetic mesh reconstruction, one posttraumatic wall defect and one metastatic tumor. There were two flap complications, one skin paddle necrosis and one wound infection. There was no significant disability of the donor limb encountered. During the two-year and seven month average follow-up, there was no recurrence of the problems except for one minor fascial dehiscence in the patient with metastatic abdominal wall tumor. Easy approach, rapid harvest, relatively large and reliable overlying fascia lata, a single dominant neurovascular pedicle, easy primary closure of the donor site, and minimal donor site morbidity all make the rectus femoris flap a good alternative flap for lower abdominal wall reconstruction. It is especially useful in a condition where synthetic mesh would be unsuitable for defects with infection or recurrent incisional hernia after radiotherapy. (author)

  18. Randomized double-blind controlled trial of roxithromycin for prevention of abdominal aortic aneurysm expansion

    Vammen, Sten; Lindholt, Jes Sanddal; Ostergaard, L

    2001-01-01

    Macrolide treatment has been reported to lower the risk of recurrent ischaemic heart disease. The influence of macrolides on the expansion rate of abdominal aortic aneurysms (AAAs) remains unknown. The aim was to investigate the effect of roxithromycin on the expansion rate of small AAAs....

  19. Postoperative findings following the Whipple procedure : determination of prevalence and morphologic abdominal CT features

    Mortele, KJ; Lemmerling, M; de Hemptinne, B; De Vos, M; De Bock, G; Kunnen, M

    2000-01-01

    This study was conducted to determine characteristic CT findings following the Whipple procedure and to evaluate the usefulness of CT in re-dieting tumor recurrence. Eighty-four postoperative abdominal CT scans and medical records of 43 patients were retrospectively reviewed. Perioperative

  20. Penetrating abdominal trauma.

    Henneman, P L

    1989-08-01

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

  1. A Newborn With Abdominal Pain.

    Alwan, Riham; Drake, Meredith; Gurria Juarez, Juan; Emery, Kathleen H; Shaaban, Aimen F; Szabo, Sara; Sobolewski, Brad

    2017-11-01

    A previously healthy 3-week-old boy presented with 5 hours of marked fussiness, abdominal distention, and poor feeding. He was afebrile and well perfused. His examination was remarkable for localized abdominal tenderness and distention. He was referred to the emergency department in which an abdominal radiograph revealed gaseous distention of the bowel with a paucity of gas in the pelvis. Complete blood cell count and urinalysis were unremarkable. His ongoing fussiness and abnormal physical examination prompted consultation with surgery and radiology. Our combined efforts ultimately established an unexpected diagnosis. Copyright © 2017 by the American Academy of Pediatrics.

  2. Recurrence in affective disorder

    Kessing, L V; Olsen, E W; Andersen, P K

    1999-01-01

    The risk of recurrence in affective disorder is influenced by the number of prior episodes and by a person's tendency toward recurrence. Newly developed frailty models were used to estimate the effect of the number of episodes on the rate of recurrence, taking into account individual frailty toward...... recurrence. The study base was the Danish psychiatric case register of all hospital admissions for primary affective disorder in Denmark during 1971-1993. A total of 20,350 first-admission patients were discharged with a diagnosis of major affective disorder. For women with unipolar disorder and for all...... kinds of patients with bipolar disorder, the rate of recurrence was affected by the number of prior episodes even when the effect was adjusted for individual frailty toward recurrence. No effect of episodes but a large effect of the frailty parameter was found for unipolar men. The authors concluded...

  3. Rectal bacteriotherapy for recurrent Clostridium difficile-associated diarrhoea

    Tvede, M; Tinggaard, M; Helms, M

    2015-01-01

    Clostridium difficile infection is one of the most common nosocomial infections. Among other alternatives to standard treatment with vancomycin for recurrent infection are faecal microbiota transplantation and rectal bacteriotherapy with a fixed mixture of intestinal bacterial strains isolated from...... for relapsing C. difficile in Denmark, 2000-2012. The primary end point was recurrent diarrhoea within 30 days after treatment. A total of 55 patients were included in this case series. Thirty-five patients (64%) had no recurrence within 30 days of bacteriotherapy. Patients with recurrence tended to be older....... difficile episode less than 6 months before bacteriotherapy. The most common adverse events were abdominal pain (10.9%) and worsening diarrhoea (4.3%). One patient was hospitalized 10 days after treatment with appendicitis, fever, and Escherichia coli bacteremia. The results from this study indicate...

  4. Abdominal aortic feminism.

    Mortimer, Alice Emily

    2014-11-14

    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. 2014 BMJ Publishing Group Ltd.

  5. Measuring Compartment Size and Gas Solubility in Marine Mammals

    2015-09-30

    bends? Effect of diving behaviour and physiology on modelled gas exchange for three species: Ziphius cavirostris, Mesoplodon densirostris and Hyperoodon...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Measuring Compartment Size and Gas Solubility in Marine...is to develop methods to estimate marine mamal tissue compartment sizes, and tissue gas solubility. We aim to improve the data available for the

  6. [Progress of midfacial fat compartments and related clinical applications].

    Wen, Lihong; Wang, Jinhuang; Li, Yang; Liu, Dalie

    2018-02-01

    To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications. The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed. Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging. As more anatomical researches have done, recent studies have shown that midfacial fat layer is broadly divided into superficial and deep layers, which are both divided into different fat compartments by fascia, ligaments, or muscles. Midfacial fat compartments tend to atrophy with age, specifically in the deep fat compartments while hypertrophy in the superficial fat compartments. Clinical applications show that fat volumetric restoration with deep medial cheek fat and Ristow's space can restore the appearance of midface effectively. In recent years, the researches of midfacial fat compartments have achieved obvious progress, which will provide new ideas and basis for fat volumetric restoration. Corresponding treatments are selected based on different sites and different layers with different aging changes, reshaping a more youthful midface.

  7. Multi-compartment Fire Modeling for Switchgear Room using CFAST

    Han, Kiyoon; Kang, Dae Il; Lim, Ho Gon

    2015-01-01

    In this study, multi-compartment fire modeling for fire propagation scenario from SWGR A to SWGR B is performed using CFAST. New fire PSA method (NUREG/CR-6850) requires that the severity factor is to be calculated by fire modeling. If fire modeling is not performed, the severity factor should be estimated as one conservatively. Also, the possibility of the damages of components and cables located at adjacent compartments should be considered. Detailed fire modeling of multi-compartment fires refers to the evaluation of fire-generated conditions in one compartment that spread to adjacent ones. In general, the severity factor for multi-compartment fire scenario is smaller than that of single compartment scenario. Preliminary quantification of Hanul Unit 3 fire PSA was performed without fire modeling. As a result of quantification, multi-compartment scenario, fire propagation scenario from switchgear room (SWGR) A to SWGR B, is one of significant contributor to the CDF. In this study, fire modeling of multi-compartment was performed by Consolidated Fire Growth and Smoke Transport (CFAST) to identify the possibility of fire propagation. As a result of fire simulation, it is identified that fire propagation has little influences

  8. Multi-compartment Fire Modeling for Switchgear Room using CFAST

    Han, Kiyoon; Kang, Dae Il; Lim, Ho Gon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    In this study, multi-compartment fire modeling for fire propagation scenario from SWGR A to SWGR B is performed using CFAST. New fire PSA method (NUREG/CR-6850) requires that the severity factor is to be calculated by fire modeling. If fire modeling is not performed, the severity factor should be estimated as one conservatively. Also, the possibility of the damages of components and cables located at adjacent compartments should be considered. Detailed fire modeling of multi-compartment fires refers to the evaluation of fire-generated conditions in one compartment that spread to adjacent ones. In general, the severity factor for multi-compartment fire scenario is smaller than that of single compartment scenario. Preliminary quantification of Hanul Unit 3 fire PSA was performed without fire modeling. As a result of quantification, multi-compartment scenario, fire propagation scenario from switchgear room (SWGR) A to SWGR B, is one of significant contributor to the CDF. In this study, fire modeling of multi-compartment was performed by Consolidated Fire Growth and Smoke Transport (CFAST) to identify the possibility of fire propagation. As a result of fire simulation, it is identified that fire propagation has little influences.

  9. Recurrent hamburger thyrotoxicosis

    Parmar, Malvinder S.; Sturge, Cecil

    2003-01-01

    RECURRENT EPISODES OF SPONTANEOUSLY RESOLVING HYPERTHYROIDISM may be caused by release of preformed hormone from the thyroid gland after it has been damaged by inflammation (recurrent silent thyroiditis) or by exogenous administration of thyroid hormone, which might be intentional or surreptitious (thyrotoxicosis factitia). Community-wide outbreaks of “hamburger thyrotoxicosis” resulting from inadvertent consumption of beef contaminated with bovine thyroid gland have been previously reported. Here we describe a single patient who experienced recurrent episodes of this phenomenon over an 11-year period and present an approach to systematically evaluating patients with recurrent hyperthyroidism. PMID:12952802

  10. Compartment in vertical flow reactor for ferruginous mine water

    Hur, Won; Cheong, Young-Wook; Yim, Gil-Jae; Ji, Sang-Woo; Hong, Ji-Hye

    2014-05-01

    Mine effluents contain varying concentrations of ferrous ion along with other metal ions. Fe(II) that quickly oxidizes to form precipitates in the presence of oxygen under net alkaline or neutral conditions. Thus, passive treatment methods are designed for the mine water to reside in an open containment area so as to allow simultaneous oxidation and precipitation of Fe(II), such as in a lagoon or an oxidation pond. A vertical flow reactor (VFR) was also suggested to remediate ferruginous mine drainage passing down through an accreting bed of ochre. However, VFR has a limited operation time until the system begins to overflow. It was also demonstrated that two-compartment VFR has a longer operation time than single compartment VFR of same size. In this study, a mathematical model was developed as a part of efforts to explore the operation of VFR, showing dynamic changes in head differences, ochre depth and Fe(II)/Fe(III) concentration in the effluent flow. The analysis shows that Fe(II) oxidation and ochre formation should be balanced with permeability of ochre bed to maximize VFR operation time and minimize residual Fe(II) in the effluent. The model demonstrates that two compartment VFR can have a longer operation time than a single-compartment VFR and that an optimum compartment ratio exists that maximize VFR operation time. Accelerated Fe(II) oxidation significantly affects the optimum ratio of compartment area and reduced residual Fe(II) in the effluent. VFR operation time can be significantly prolonged by increasing the rate of ochre formation not by accelerated Fe(II) oxidation. Taken together, ochre forms largely in the first compartment while overflowed mine water with reduced iron contents is efficiently filtered in the second compartment. These results provide us a better understanding of VFR operation and optimum design criteria for maximum operation time in a two-compartment VFR. Rapid ochre accretion in the first compartment maintains constant hydraulic

  11. Recurrent Takotsubo Cardiomyopathy Related to Recurrent Thyrotoxicosis.

    Patel, Keval; Griffing, George T; Hauptman, Paul J; Stolker, Joshua M

    2016-04-01

    Takotsubo cardiomyopathy, or transient left ventricular apical ballooning syndrome, is characterized by acute left ventricular dysfunction caused by transient wall-motion abnormalities of the left ventricular apex and mid ventricle in the absence of obstructive coronary artery disease. Recurrent episodes are rare but have been reported, and several cases of takotsubo cardiomyopathy have been described in the presence of hyperthyroidism. We report the case of a 55-year-old woman who had recurrent takotsubo cardiomyopathy, documented by repeat coronary angiography and evaluations of left ventricular function, in the presence of recurrent hyperthyroidism related to Graves disease. After both episodes, the patient's left ventricular function returned to normal when her thyroid function normalized. These findings suggest a possible role of thyroid-hormone excess in the pathophysiology of some patients who have takotsubo cardiomyopathy.

  12. Wrist arthrography: The value of the three compartment injection technique

    Levinsohn, E.M.; Coren, A.B.; Palmer, A.K.; Zinberg, E.

    1987-10-01

    Arthrography of the wrist was performed on 50 consecutive patients with obscure post-traumatic wrist pain by injecting contrast separately into the radiocarpal joint, midcarpal compartment, and distal radioulnar joint. When distal radioulnar joint and midcarpal compartment injections were added to the standard radiocarpal injection, many significant unsuspected abnormalities were identified. Of the 25 triangular fibrocartilage complex abnormalities identified, six (24%) were found only with the distal radioulnar joint injection. Of the 29 abnormal communications between the midcarpal compartment and the radiocarpal joint, ten (35%) were found only with the midcarpal injection. Similarly, five of 29 (17%) of the abnormal radiocarpal-midcarpal communications would have been missed if a midcarpal injection alone had been performed. These findings indicate that separate injections into the radiocarpal joint, midcarpal compartment, and distal radioulnar joint are needed to identify a large number of abnormalities not seen with injections into one compartment alone.

  13. Computation of thermal comfort inside a passenger car compartment

    Mezrhab, A.; Bouzidi, M.

    2006-01-01

    This paper describes a numerical model to study the behaviour of thermal comfort inside the passenger car compartment according to climatic conditions and materials that compose the vehicle. The specifically developed numerical model is based on the nodal method and the finite difference method. Its specificities are: (i) the transient mode, (ii) the taking into account of the combined convection, conduction and radiation heat transfer, (iii) the coupling of two spectral bands (short-wave and long-wave radiation) and two solar fluxes (beam and diffuse). The compartment is subdivided in several solid nodes (materials constituting the compartment) and fluid nodes (volumes of air inside the compartment). The establishment of the heat balance for each node gives the evolution of its temperature. Effects of solar radiation, types of glazing, car colour and radiative properties of materials constituting the compartment are investigated

  14. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type of examination. ...

  15. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... child's abdominal ultrasound examination. Doppler ultrasound , also called color Doppler ultrasonography, is a special ultrasound technique that ... and processes the sounds and creates graphs or color pictures that represent the flow of blood through ...

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) ... uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, ...

  17. Children's (Pediatric) Abdominal Ultrasound Imaging

    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

    Full Text Available ... of an apparent enlarged abdominal organ identify the location of abnormal fluid in the abdomen help determine ... places the transducer on the skin in various locations, sweeping over the area of interest or angling ...

  19. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... arteries and veins in the abdomen, arms, legs, neck and/or brain (in infants and children) or ... help a physician determine the source of abdominal pain, such as gallstones, kidney stones, abscesses or an ...

  20. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging can also: ... be necessary. Your doctor will explain the exact reason why another exam is requested. Sometimes a follow- ...

  1. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... kidneys. top of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  2. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... ultrasound images are captured in real-time, they can show the structure and movement of the body's ... kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... apparent enlarged abdominal organ identify the location of abnormal fluid in the abdomen help determine causes of ... are used to extract sample cells from an abnormal area for laboratory testing. Ultrasound may also be ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... imaging produces pictures of the internal organs and blood vessels located within a child's abdomen. A Doppler ultrasound study may be part of a child's abdominal ultrasound ...

  5. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... kidneys. top of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  6. Intra-abdominal tuberculous peritonitis

    Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B.; Hennes, P.; Pueschel, W.; Karadiakos, N.

    2001-01-01

    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.)

  7. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic ... of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and ...

  8. Linking Abdominal Obesity and Dyslipidemia

    Pedro Enrique Miguel Soca

    2011-10-01

    Full Text Available Considering as a start point the discussion of an article published by this same journal (Finlay in its previous issue, this letter deals with some alterations associating abdominal obesity and dyslipidemia.

  9. Intra-abdominal tuberculous peritonitis

    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.)

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... various body organs such as the liver or kidneys. top of page What are some common uses ... appendix stomach/ pylorus liver gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can ...

  11. Recovery after abdominal wall reconstruction

    Jensen, Kristian Kiim

    2017-01-01

    Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function......, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction. Study...... was lacking. Study II was a case-control study of the effects of an enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction for a giant hernia. Sixteen consecutive patients were included prospectively after the implementation of a new enhanced recovery after surgery...

  12. Clear Cell Adenocarcinoma Arising from Abdominal Wall Endometriosis

    Thouraya Achach

    2008-01-01

    Full Text Available Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

  13. Ectopic intra-abdominal fascioliasis

    ÖNGÖREN, Ali Ulvi

    2009-01-01

    Human fascioliasis, caused by Fasciola hepatica, is emerging as an important chronic zoonotic disease in many areas of the world, including Turkey. It primarily involves the liver and may also cause severe damage in the tissue. Herein we report on a patient with ectopic intra-abdominal fascioliasis that presented to our clinic with abdominal pain and distention. Physical and radiological examination as well as an exploratory laparotomy revealed a 10 × 10-cm mass in the splenic flexura of the ...

  14. Abdominal ultrasonography, 2nd Ed

    Goldberg, B.B.

    1984-01-01

    This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy

  15. CT findings in abdominal actinomycosis

    Lee, In Jae; Ha, Hyun Kwon; Lee, Moon Gyu; Kim, Pyo Nyun; Auh, Yong Ho

    1999-01-01

    Abdominal actinomycosis is a chronic, progressive, suppurative disease with a favorable response to intravenous treatment with penicillin. In many instances, however, its clinical and radiological findings may overlap with those of other inflammatory and neoplastic conditions, and the familiarity with the various radiological features can thus avoid diagnostic delays. The purpose of this paper is to describe and discuss the CT findings of abdominal actinomycosis

  16. Intra-abdominal vacuum-assisted closure (VAC) after necrosectomy for acute necrotising pancreatitis: preliminary experience.

    Sermoneta, D; Di Mugno, M; Spada, P L; Lodoli, C; Carvelli, M E; Magalini, S C; Cavicchioni, C; Bocci, M G; Martorelli, F; Brizi, M G; Gui, D

    2010-12-01

    Infection of pancreatic necrosis, although present in less than 10% of acute pancreatitis, carries a high risk of mortality; debridment and drainage of necrosis is the treatment of choice, followed by 'open' or 'close' abdomen management. We recently introduced the use of intra-abdominal vacuum sealing after a classic necrosectomy and laparostomy. Two patients admitted to ICU for respiratory insufficiency and a diagnosis of severe acute pancreatitis developed pancreatic necrosis and were treated by necrosectomy, lesser sac marsupialisation and posterior lumbotomic opening. Both of the patients recovered from pancreatitis and a good healing of laparostomic wounds was obtained with the use of the VAC system. Most relevant advantages of this technique seem to be: the prevention of abdominal compartment syndrome, the simplified nursing of patients and the reduction of time to definitive abdominal closure. © 2010 The Authors. Journal Compilation © 2010 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  17. Blunt abdominal trauma in children.

    Schonfeld, Deborah; Lee, Lois K

    2012-06-01

    This review will examine the current evidence regarding pediatric blunt abdominal trauma and the physical exam findings, laboratory values, and radiographic imaging associated with the diagnosis of intra-abdominal injuries (IAI), as well as review the current literature on pediatric hollow viscus injuries and emergency department disposition after diagnosis. The importance of the seat belt sign on physical examination and screening laboratory data remains controversial, although screening hepatic enzymes are recommended in the evaluation of nonaccidental trauma to identify occult abdominal organ injuries. Focused Assessment with Sonography for Trauma (FAST) has modest sensitivity for hemoperitoneum and IAI in the pediatric trauma patient. Patients with concern for undiagnosed IAI, including bowel injury, may be considered for hospital admission and serial abdominal exams without an increased risk of complications, if an exploratory laparotomy is not performed emergently. Although the FAST exam is not recommended as the sole screening tool to rule out IAI in hemodynamically stable trauma patients, it may be used in conjunction with the physical exam and laboratory findings to identify children at risk for IAI. Children with a normal physical exam and normal abdominal CT may not require routine hospitalization after blunt abdominal trauma.

  18. Functional outcome of tibial fracture with acute compartment syndrome and correlation to deep posterior compartment pressure.

    Goyal, Saumitra; Naik, Monappa A; Tripathy, Sujit Kumar; Rao, Sharath K

    2017-05-18

    To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome (ACS) and to correlate it with functional outcome. Thirty-two tibial fractures with ACS were evaluated clinically and the deep posterior compartment pressure was measured. Urgent fasciotomy was needed in 30 patients. Definite surgical fixation was performed either primarily or once fasciotomy wound was healthy. The patients were followed up at 3 mo, 6 mo and one year. At one year, the functional outcome [lower extremity functional scale (LEFS)] and complications were assessed. Three limbs were amputated. In remaining 29 patients, the average times for clinical and radiological union were 25.2 ± 10.9 wk (10 to 54 wk) and 23.8 ± 9.2 wk (12 to 52 wk) respectively. Nine patients had delayed union and 2 had nonunion who needed bone grafting to augment healing. Most common complaint at follow up was ankle stiffness (76%) that caused difficulty in walking, running and squatting. Of 21 patients who had paralysis at diagnosis, 13 (62%) did not recover and additional five patients developed paralysis at follow-up. On LEFS evaluation, there were 14 patients (48.3%) with severe disability, 10 patients (34.5%) with moderate disability and 5 patients (17.2%) with minimal disability. The mean pressures in patients with minimal disability, moderate disability and severe disability were 37.8, 48.4 and 58.79 mmHg respectively ( P fractures causes severe functional disability in majority of patients. These patients are prone for delayed union and nonunion; however, long term disability is mainly because of severe soft tissue contracture. Intra-compartmental pressure (ICP) correlates with functional disability; patients with relatively high ICP are prone for poor functional outcome.

  19. Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes

    John G. Skedros

    2018-01-01

    Full Text Available We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.

  20. Trace elements distribution in environmental compartments

    Queiroz, Juliana C. de; Peres, Sueli da Silva; Godoy, Maria Luiza D.P.

    2017-01-01

    Trace elements term defines the presence of low concentrations metals at environment. Some of them are considered biologically essential, as Co, Cu and Mn. Others can cause detriment to environment and human health, as Pb, Cd, Hg, As, Ti and U. A large number of them have radioactive isotopes, implying the evaluation of risks for human health should be done considering the precepts of environmental radiological protection. The ecosystem pollution with trace elements generates changes at the geochemistry cycle of these elements and in environmental quality. Soils have single characteristics when compared with another components of biosphere (air, water and biota), cause they introduce themselves not only as a drain towards contaminants, but also as natural buffer that control the transport of chemical elements and other substances for atmosphere, hydrosphere and biota. The main purpose of environmental monitoring program is to evaluate the levels of contaminants in the various compartments of the environment: natural or anthropogenic, and to assess the contribution of a potential contaminant source on the environment. Elemental Composition for the collected samples was determined by inductively coupled plasma mass spectroscopy. The main objective of this work was to evaluate the map baseline of concentration of interest trace elements in environmental samples of water, sediment and soil from Environmental Monitoring Program of Instituto de Radioprotecao e Dosimetria (IRD). The samples were analyzed using an inductively coupled plasma mass spectrometer (ICP-MS) at IRD. >From the knowledge of trace elements concentrations, could be evaluated the environmental quality parameters at the studied ecosystems. The data allowed evaluating some relevant aspects of the study of trace elements in soil and aquatic systems, with emphasis at the distribution, concentration and identification of main anthropic sources of contamination at environment. (author)

  1. Trace elements distribution in environmental compartments

    Queiroz, Juliana C. de; Peres, Sueli da Silva; Godoy, Maria Luiza D.P., E-mail: suelip@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2017-11-01

    Trace elements term defines the presence of low concentrations metals at environment. Some of them are considered biologically essential, as Co, Cu and Mn. Others can cause detriment to environment and human health, as Pb, Cd, Hg, As, Ti and U. A large number of them have radioactive isotopes, implying the evaluation of risks for human health should be done considering the precepts of environmental radiological protection. The ecosystem pollution with trace elements generates changes at the geochemistry cycle of these elements and in environmental quality. Soils have single characteristics when compared with another components of biosphere (air, water and biota), cause they introduce themselves not only as a drain towards contaminants, but also as natural buffer that control the transport of chemical elements and other substances for atmosphere, hydrosphere and biota. The main purpose of environmental monitoring program is to evaluate the levels of contaminants in the various compartments of the environment: natural or anthropogenic, and to assess the contribution of a potential contaminant source on the environment. Elemental Composition for the collected samples was determined by inductively coupled plasma mass spectroscopy. The main objective of this work was to evaluate the map baseline of concentration of interest trace elements in environmental samples of water, sediment and soil from Environmental Monitoring Program of Instituto de Radioprotecao e Dosimetria (IRD). The samples were analyzed using an inductively coupled plasma mass spectrometer (ICP-MS) at IRD. >From the knowledge of trace elements concentrations, could be evaluated the environmental quality parameters at the studied ecosystems. The data allowed evaluating some relevant aspects of the study of trace elements in soil and aquatic systems, with emphasis at the distribution, concentration and identification of main anthropic sources of contamination at environment. (author)

  2. Compartmented pyruvate in perfused working heart

    Buenger, R.

    1985-01-01

    Pyruvate compartmentation and lactate dehydrogenase (LDH) were studied in isolated perfused working guinea pig hearts. The mean intracellular pyruvate (Pyr) contents increased with perfusate Pyr (0-2 mM) but varied only slightly with glucose (0-10 mM) and additional insulin (0.04-5 U/l), respectively. With 5-10 mM glucose plus 5 U/l insulin, but not with Pyr or lactate (Lac) as substrates, a near equilibrium between the LDH and the glycerol-3-phosphate dehydrogenase seemed to exist. Evidence for an inhibitory effect of Pyr on the activity of the LDH system of the perfused hearts was not obtained. With [U- 14 C]glucose as sole substrate, the specific activity of coronary venous Lac was near half that of precursor glucose. 14 CO 2 production was thus in quantitative agreement with rates of pyruvate oxidation that were determined as glucose uptake minus (Pyr + Lac) release. In contrast, with 0.2 mM [1- 14 C]Pyr plus 5 mM glucose, the ratio of 14 CO 2 production to specific activity of Lac overestimated Pyr oxidation judged from myocardial substrate balances and O 2 uptake, respectively; here, at least three pools of [ 14 C]HCO-3 and [ 14 C]lac, respectively, were kinetically demonstrable during washout of trace amounts of 14 C-labeled Pyr. Evidently, the specific activity of Lac was equivalent to that of mitochondrial oxidized Pyr provided [ 14 C]glucose was the sole or major precursor of cellular pyruvate. However, exogenously applied [1- 14 C]Pyr of high specific activity seemed to induce intracellular formation of both a highly and lowly labeled Pyr; the latter Pyr compartment did not seem in ready equilibrium with the cell physiologically prevailing highly labeled Pyr pool

  3. Persistent and recurrent hyperparathyroidism.

    Guerin, Carole; Paladino, Nunzia Cinzia; Lowery, Aoife; Castinetti, Fréderic; Taieb, David; Sebag, Fréderic

    2017-06-01

    Despite remarkable progress in imaging modalities and surgical management, persistence or recurrence of primary hyperparathyroidism (PHPT) still occurs in 2.5-5% of cases of PHPT. The aim of this review is to expose the management of persistent and recurrent hyperparathyroidism. A literature search was performed on MEDLINE using the search terms "recurrent" or "persistent" and "hyperparathyroidism" within the past 10 years. We also searched the reference lists of articles identified by this search strategy and selected those we judged relevant. Before considering reoperation, the surgeon must confirm the diagnosis of PHPT. Then, the patient must be evaluated with new imaging modalities. A single adenoma is found in 68% of cases, multiglandular disease in 28%, and parathyroid carcinoma in 3%. Others causes (<1%) include parathyromatosis and graft recurrence. The surgeon must balance the benefits against the risks of a reoperation (permanent hypocalcemia and recurrent laryngeal nerve palsy). If surgery is necessary, a focused approach can be considered in cases of significant imaging foci, but in the case of multiglandular disease, a bilateral neck exploration could be necessary. Patients with multiple endocrine neoplasia syndromes are at high risk of recurrence and should be managed regarding their hereditary pathology. The cure rate of persistent-PHPT or recurrent-PHPT in expert centers is estimated from 93 to 97%. After confirming the diagnosis of PHPT, patients with persistent-PHPT and recurrent-PHPT should be managed in an expert center with all dedicated competencies.

  4. Evaluation of Cases of Abdominal Wall Endometriosis at Universidade Estadual de Campinas in a period of 10 Years

    Yela, Daniela Angerame; Trigo, Lucas; Benetti-Pinto, Cristina Laguna

    2017-01-01

    Abstract Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical ...

  5. Abdominal wall hernias: computed tomography findings

    D'Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo.

    2005-01-01

    Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)

  6. Essential Thrombocytosis-Associated Thromboembolism in the Abdominal Aorta

    Byung Kwon Chong

    2016-10-01

    Full Text Available Essential thrombocytosis (ET is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient’s platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up.

  7. Hydrogen Peroxide Probes Directed to Different Cellular Compartments

    Malinouski, Mikalai; Zhou, You; Belousov, Vsevolod V.; Hatfield, Dolph L.; Gladyshev, Vadim N.

    2011-01-01

    Background Controlled generation and removal of hydrogen peroxide play important roles in cellular redox homeostasis and signaling. We used a hydrogen peroxide biosensor HyPer, targeted to different compartments, to examine these processes in mammalian cells. Principal Findings Reversible responses were observed to various redox perturbations and signaling events. HyPer expressed in HEK 293 cells was found to sense low micromolar levels of hydrogen peroxide. When targeted to various cellular compartments, HyPer occurred in the reduced state in the nucleus, cytosol, peroxisomes, mitochondrial intermembrane space and mitochondrial matrix, but low levels of the oxidized form of the biosensor were also observed in each of these compartments, consistent with a low peroxide tone in mammalian cells. In contrast, HyPer was mostly oxidized in the endoplasmic reticulum. Using this system, we characterized control of hydrogen peroxide in various cell systems, such as cells deficient in thioredoxin reductase, sulfhydryl oxidases or subjected to selenium deficiency. Generation of hydrogen peroxide could also be monitored in various compartments following signaling events. Conclusions We found that HyPer can be used as a valuable tool to monitor hydrogen peroxide generated in different cellular compartments. The data also show that hydrogen peroxide generated in one compartment could translocate to other compartments. Our data provide information on compartmentalization, dynamics and homeostatic control of hydrogen peroxide in mammalian cells. PMID:21283738

  8. Hydrogen peroxide probes directed to different cellular compartments.

    Mikalai Malinouski

    2011-01-01

    Full Text Available Controlled generation and removal of hydrogen peroxide play important roles in cellular redox homeostasis and signaling. We used a hydrogen peroxide biosensor HyPer, targeted to different compartments, to examine these processes in mammalian cells.Reversible responses were observed to various redox perturbations and signaling events. HyPer expressed in HEK 293 cells was found to sense low micromolar levels of hydrogen peroxide. When targeted to various cellular compartments, HyPer occurred in the reduced state in the nucleus, cytosol, peroxisomes, mitochondrial intermembrane space and mitochondrial matrix, but low levels of the oxidized form of the biosensor were also observed in each of these compartments, consistent with a low peroxide tone in mammalian cells. In contrast, HyPer was mostly oxidized in the endoplasmic reticulum. Using this system, we characterized control of hydrogen peroxide in various cell systems, such as cells deficient in thioredoxin reductase, sulfhydryl oxidases or subjected to selenium deficiency. Generation of hydrogen peroxide could also be monitored in various compartments following signaling events.We found that HyPer can be used as a valuable tool to monitor hydrogen peroxide generated in different cellular compartments. The data also show that hydrogen peroxide generated in one compartment could translocate to other compartments. Our data provide information on compartmentalization, dynamics and homeostatic control of hydrogen peroxide in mammalian cells.

  9. Lower limb compartment syndrome following laparoscopic colorectal surgery: a review.

    Rao, M M; Jayne, D

    2011-05-01

      In spite of recent advances in technology and technique, laparoscopic colorectal surgery is associated with increased operating times when compared with open surgery. This increases the risk of acute lower limb compartment syndrome. The aim of this review was to gain a better understanding of postoperative lower limb compartment syndrome following laparoscopic colorectal surgery and to suggest strategies to avoid its occurrence. A MEDLINE search was performed using the keywords 'compartment syndrome', 'laparoscopic surgery' and 'Lloyd-Davies position' between 1970 and 2008. All relevant articles were retrieved and reviewed. A total of 54 articles were retrieved. Of the 30 articles in English, five were reviews, six were original articles and 19 were case reports, of which only one was following laparoscopic colorectal surgery. The remaining 24 were non-English articles. Of these, two were reviews and 22 were case reports, of which only one was following laparoscopic colorectal surgery. The incidence of acute compartment syndrome following laparoscopic colorectal surgery is unknown. The following are believed to be risk factors for acute lower limb compartment syndrome: the Lloyd-Davies operating position with exaggerated Trendelenburg tilt, prolonged operative times and improper patient positioning. Simple strategies are suggested to reduce its occurrence. Simple preventative measures have been identified which may help to reduce the incidence of acute lower limb compartment syndrome. However, if suspected, timely surgical intervention with four-compartment fasciotomy remains the standard of care. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  10. Stochastic Turing Patterns: Analysis of Compartment-Based Approaches

    Cao, Yang; Erban, Radek

    2014-01-01

    © 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.

  11. Characteristics of patients with chronic exertional compartment syndrome.

    Davis, Daniel E; Raikin, Steven; Garras, David N; Vitanzo, Peter; Labrador, Hallie; Espandar, Ramin

    2013-10-01

    Chronic exertional compartment syndrome (CECS) is a condition that causes reversible ischemia and lower extremity pain during exercise. To date there are few large studies examining the characteristics of patients with CECS. This study aimed to present these characteristics by examining the largest published series of patients with a confirmed diagnosis of the disorder. An IRB-approved, retrospective review was undertaken of patients with a suspected diagnosis of CECS undergoing pre- and postexercise compartment pressure testing between 2000 and 2012. Patients were evaluated for gender, age, duration of symptoms, pain level, specific compartments involved, compartment pressure measurements, and participation and type of athletics. Two-hundred twenty-six patients (393 legs) underwent compartment pressure testing. A diagnosis of CECS was made in 153 (67.7%) patients and 250 (63.6%) legs with elevated compartment measurements; average age of the patients was 24 years (range, 13-69 years). Female patients accounted for 92 (60.1%) of those with elevated pressures. Anterior and lateral compartment pressures were elevated most frequently, with 200 (42.5%) and 167 (35.5%) compartments, respectively. One hundred forty-one (92.2%) patients reported participation in sports, with running being the most common individual sport and soccer being the most common team sport. Duration of pain prior to diagnosis averaged 28 months. Although there is ample literature pertaining to the diagnostic criteria and treatment algorithm of the condition, few papers have described the type of patient most likely to develop CECS. This is the largest study to date to evaluate the type of patient likely to present with chronic exertional compartment syndrome. Level III, retrospective review.

  12. Stochastic Turing Patterns: Analysis of Compartment-Based Approaches

    Cao, Yang

    2014-11-25

    © 2014, Society for Mathematical Biology. Turing patterns can be observed in reaction-diffusion systems where chemical species have different diffusion constants. In recent years, several studies investigated the effects of noise on Turing patterns and showed that the parameter regimes, for which stochastic Turing patterns are observed, can be larger than the parameter regimes predicted by deterministic models, which are written in terms of partial differential equations (PDEs) for species concentrations. A common stochastic reaction-diffusion approach is written in terms of compartment-based (lattice-based) models, where the domain of interest is divided into artificial compartments and the number of molecules in each compartment is simulated. In this paper, the dependence of stochastic Turing patterns on the compartment size is investigated. It has previously been shown (for relatively simpler systems) that a modeler should not choose compartment sizes which are too small or too large, and that the optimal compartment size depends on the diffusion constant. Taking these results into account, we propose and study a compartment-based model of Turing patterns where each chemical species is described using a different set of compartments. It is shown that the parameter regions where spatial patterns form are different from the regions obtained by classical deterministic PDE-based models, but they are also different from the results obtained for the stochastic reaction-diffusion models which use a single set of compartments for all chemical species. In particular, it is argued that some previously reported results on the effect of noise on Turing patterns in biological systems need to be reinterpreted.

  13. Abdominal imaging in AIDS patients

    Zhao Dawei; Wang Wei; Yuan Chunwang; Jia Cuiyu; Zhao Xuan; Zhang Tong; Ma Daqing

    2007-01-01

    Objective: To evaluate abdominal imaging in AIDS. Methods: The imaging examinations (including US, CT and MR) of 6 patients with AIDS associated abdominal foci were analysed retrospectively. All the cases were performed US, and CT scan, of which 4 performed enhanced CT scan and 1 with MR. Results: Abdominal tuberculosis were found in 4 patients, including abdominal lymph nodes tuberculosis (3 cases) and pancreatic tuberculosis (1 case). The imaging of lymph nodes tuberculosis typically showed enlarged peripheral tim enhancement with central low-attenuation on contrast-enhanced CT. Pancreatic tuberculosis demonstrated low-attenuation area in pancreatic head and slightly peripheral enhancement. Disseminated Kaposi's sarcoma was seen in 1 case: CT and MRI scan demonstrated tumour infiltrated along hepatic portal vein and bronchovascular bundles. Pelvic tumor was observed in 1 case: CT scan showed large mass with thick and irregular wall and central low attenuation liquefacient necrotic area in the pelvic cavity. Conclusion: The imaging findings of AIDS with abdominal foci is extraordinarily helpful to the diagnosis of such disease. Tissue biopsy is needed to confirm the diagnosis. (authors)

  14. RECURRENT CROUP IN CHILDREN

    S. L. Piskunova

    2014-01-01

    Full Text Available The article presents the results of examination of 1849 children, entering children's infectioushospitalofVladivostokwith the clinical picture of croup of viral etiology. The clinical features of primary and recurrent croup are described. Frequency of recurrent croup inVladivostokis 8%. Children with a recurrent croup had the burdened premorbid background, and also persistent herpetic infections (cytomegalic infection in 42,9% cases, cytomegalic infection in combination with the herpes simplex virus -1. Frequency of croups substantially rose in the period of epidemic of influenza.

  15. The subapical compartment : a traffic center in membrane polarity development

    Hoekstra, D; Tyteca, D; van IJzendoorn, SCD

    2004-01-01

    Spatially separated apical and basolateral plasma membrane domains that have distinct functions and molecular compositions are a characteristic feature of epithelial cell polarity. The subapical compartment (SAC), also known as the common endosome (CE), where endocytic pathways from both surfaces

  16. 14 CFR 25.365 - Pressurized compartment loads.

    2010-01-01

    ... flight, and stress concentrations and fatigue effects must be accounted for. (c) If landings may be made... small compartment. The size Ho must be computed by the following formula: Ho=PAs where, Ho=Maximum...

  17. Turbofan Engine Core Compartment Vent Aerodynamic Configuration Development Methodology

    Hebert, Leonard J.

    2006-01-01

    This paper presents an overview of the design methodology used in the development of the aerodynamic configuration of the nacelle core compartment vent for a typical Boeing commercial airplane together with design challenges for future design efforts. Core compartment vents exhaust engine subsystem flows from the space contained between the engine case and the nacelle of an airplane propulsion system. These subsystem flows typically consist of precooler, oil cooler, turbine case cooling, compartment cooling and nacelle leakage air. The design of core compartment vents is challenging due to stringent design requirements, mass flow sensitivity of the system to small changes in vent exit pressure ratio, and the need to maximize overall exhaust system performance at cruise conditions.

  18. Environmental fate and transport analysis with compartment modeling

    Little, Keith W

    2012-01-01

    .... Discussing various modeling issues in a single volume, this text provides an introduction to a specific numerical modeling technique called the compartment approach and offers a practical user's guide to the GEM...

  19. Chronic exertional compartment syndrome in the forearm of a rower

    ICP) measurement (Fig. 1). Testing of the flexor compart- ments revealed a raised resting pressure of 16 ... the following values suggestive of CECS in the lower limb: A pre- ... toxin decreases muscle mass and therefore causes a reduction of.

  20. CT evaluation of abdominal trauma

    Huang Ruiting

    2004-01-01

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

  1. Abdominal radiation causes bacterial translocation

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-01-01

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

  2. Abdominal wall hernia and pregnancy

    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...

  3. Subtotal versus total abdominal hysterectomy

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

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  4. Contemporary imaging in abdominal emergencies

    Sivit, Carlos J.

    2008-01-01

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

  5. Radiological evaluation of abdominal trauma

    Ahn, K. S.; Cho, Y. H.; Kim, O.

    1982-01-01

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

  6. Microbial investigations of deep geological compartments

    Barsotti, V.; Sergeant, C.; Vesvres, M.H.; Joulian, C.; Coulon, S.; Le Marrec, C.; Garrido, F.

    2010-01-01

    Document available in extended abstract form only. Deep sedimentary rocks are now considered to contain a significant part of the total bacterial population, but are microbiologically unexplored. The drilling down to the base of the Triassic (1980 meters deep) in the geological formations of the eastern Paris Basin performed by ANDRA (EST433) in 2008 provides us a good opportunity to explore the deep biosphere. We conditioned and sub-sampled on the coring site, in as aseptic conditions as possible, the nine cores: two in the Callovo-Oxfordian clay, two in the Dogger, five in the Triassic compartments. In addition to storage at atmospheric pressure, a portion of the five Triassic samples was placed in a 190 bars pressurized bars chamber to investigate the influence of the conservation pressure factor on the found microflora. In parallel, in order to evaluate a potential bacterial contamination of the core by the drilling fluids, samples of mud just before each sample drilling were taken and analysed. The microbial exploration we started can be divided in two parts: - A cultural approach in different culture media for six metabolic groups to try to find microbial cells still viable. This type of experiment is difficult because of the small proportion of cultivable species, especially in these extreme environmental samples. - A molecular approach by direct extraction of genomic DNA from the geological samples to explore a larger biodiversity. Here, the limits are the difficulties to extract DNA from these low biomass containing rocks. The five Triassic samples were partly crushed in powder and inoculated in the six culture media with four NaCl concentrations, because this type of rock is known as saline or hyper-saline, and incubated at three temperatures: 30 deg. C, 55 deg. C under agitation and 70 deg. C. First results will be presented. The direct extraction of DNA needs a complete method optimisation to adapt existent procedures (using commercial kit and classical

  7. Topology Optimization of Spacecraft Transfer Compartment

    A. A. Borovikov

    2016-01-01

    Full Text Available IntroductionThe subject of this research is topology optimization of the adapter of a spacecraft transfer compartment. The finite element topology optimization [1] is widely used for simple structure elements [6, 7]. It is argued that using this method in conjunction with additive technology (3D - printing it is possible to create construction designs with the best weight characteristics. However, the paper shows that when applying this method to a complex construction design the optimization results are highly sensitive to optimization algorithm parameters. The goal of this research is to study parameters of the topology optimization algorithm and the influence of their variations on results.1.      Problem formulation   A commercial software Altair HyperWorks/OptiStruct (student’s license performed numerical calculations. The paper presents a detailed description of the finite element model.The main features of the proposed model are as follows:-          Simplicity with non-complicated geometry;-          Building a finite element model in terms of computing time minimization;-          Using the lumped mass elements to simulate the impacts of the conjugates on the adapter;-          A limit of material strength, decreased by an order of magnitude, to eliminate stress concentrators;-          The gravitational load applied corresponds to the loads for the Angara-A5 launcher [8]. 2.      Method of solutionA brief description of the SIMP-method realized in the Altair HyperWorks/OptiStruct software is given.3.      ResultsPerformed numerical calculations, and shown the influence of variations of algorithm parameters (DISCRETE, MATINIT, MINDIM, MAXDIM on construction design as well as the parameters SINGLE and SPLIT used to reveal restrictions on manufacturing.Shown that, depending on variations of parameters, an adapter construction strives to «truss» or «shell» type. Described

  8. Can preeclampsia be considered a renal compartment syndrome? A hypothesis and analysis of the literature.

    Reuter, David G; Law, Yuk; Levy, Wayne C; Seslar, Stephen P; Zierler, R Eugene; Ferguson, Mark; Chattra, James; McQuinn, Tim; Liu, Lenna L; Terry, Mark; Coffey, Patricia S; Dimer, Jane A; Hanevold, Coral; Flynn, Joseph T; Stapleton, F Bruder

    2016-11-01

    The morbidity and mortality associated with preeclampsia is staggering. The physiology of the Page kidney, a condition in which increased intrarenal pressure causes hypertension, appears to provide a unifying framework to explain the complex pathophysiology. Page kidney hypertension is renin-mediated acutely and ischemia-mediated chronically. Renal venous outflow obstruction also causes a Page kidney phenomenon, providing a hypothesis for the increased vulnerability of a subset of women who have what we are hypothesizing is a "renal compartment syndrome" due to inadequate ipsilateral collateral renal venous circulation consistent with well-known variation in normal venous anatomy. Dynamic changes in renal venous anatomy and physiology in pregnancy appear to correlate with disease onset, severity, and recurrence. Since maternal recumbent position is well known to affect renal perfusion and since chronic outflow obstruction makes women vulnerable to the ischemic/inflammatory sequelae, heightened awareness of renal compartment syndrome physiology is critical. The anatomic and physiologic insights provide immediate strategies to predict and prevent preeclampsia with straightforward, low-cost interventions that make renewed global advocacy for pregnant women a realistic goal. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  9. Activation amplitude and temporal synchrony among back extensor and abdominal muscles during a controlled transfer task: comparison of men and women.

    Hubley-Kozey, Cheryl L; Butler, Heather L; Kozey, John W

    2012-08-01

    Muscle synergies are important for spinal stability, but few studies examine temporal responses of spinal muscles to dynamic perturbations. This study examined activation amplitudes and temporal synergies among compartments of the back extensor and among abdominal wall muscles in response to dynamic bidirectional moments of force. We further examined whether responses were different between men and women. 19 women and 18 men performed a controlled transfer task. Surface electromyograms from bilateral sites over 6 back extensor compartments and 6 abdominal wall muscle sites were analyzed using principal component analysis. Key features were extracted from the measured electromyographic waveforms capturing amplitude and temporal variations among muscle sites. Three features explained 97% of the variance. Scores for each feature were computed for each measured waveform and analysis of variance found significant (pWomen had more differences among muscle sites than men for the lateral flexion moment feature. For the abdominal wall muscles the oblique muscles responded with synergies related to fiber orientation, with women having higher amplitudes and more responsiveness to the lateral flexion moment than men. Synergies between the abdominal and back extensor sites as the moment demands change are discussed. These findings illustrate differential activation among erector spinae compartments and abdominal wall muscle sites supporting a highly organized pattern of response to bidirectional external moments with asynchronies more apparent in women. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Penetrating abdominal injuries: management controversies

    Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

    2009-01-01

    Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

  11. Penetrating abdominal injuries: management controversies

    Velmahos George C

    2009-04-01

    Full Text Available Abstract Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries.

  12. Abdominal surgery in neonatal foals.

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  13. CT appearances of abdominal tuberculosis

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

    2012-06-15

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

  14. CT appearances of abdominal tuberculosis

    Lee, W.-K.; Van Tonder, F.; Tartaglia, C.J.; Dagia, C.; Cazzato, R.L.; Duddalwar, V.A.; Chang, S.D.

    2012-01-01

    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.

  15. Secondary abdominal appendicular ectopic pregnancy.

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

    2007-01-01

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

  16. Torsion of abdominal appendages presenting with acute abdominal pain

    Al-Jaberi, Tareq M.; Gharabeih, Kamal I.; Yaghan, Rami J.

    2000-01-01

    Diseases of abnormal appendages are rare causes of abdominal pain in all age groups. Nine patients with torsion and infraction of abdominal appendages were retrospectively reviewed. Four patients had torsion and infarction of the appendices epiploicae, four patients had torsion and infarction of the falciform ligament. The patient with falciform ligament disease represents the first reported case of primary torsion and infarction of the falciform ligament, and the patient with the transverse colon epiplocia represents the first reported case of vibration-induced appendix epiplocia torsion and infarction. The patient with the falciform ligament disease presented with a tender upper abdominal mass and the remaining patients were operated upon with the preoperative diagnosis of acute appendicitis. The presence of normal appendix with free serosanguinous fluid in the peritoneal cavity should raise the possibility of a disease and calls for further evaluation of the intra-abdominal organs. If the diagnosis is suspected preoperatively, CT scan and ultrasound may lead to a correct diagnosis and possibly conservative management. Laparoscopy is playing an increasing diagnostic and therapeutic role in such situations. (author)

  17. Diagnosis in acute abdominal pain and ongoing abdominal sepsis

    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

  18. Pressure Measurement Techniques for Abdominal Hypertension: Conclusions from an Experimental Model.

    Chopra, Sascha Santosh; Wolf, Stefan; Rohde, Veit; Freimann, Florian Baptist

    2015-01-01

    Introduction. Intra-abdominal pressure (IAP) measurement is an indispensable tool for the diagnosis of abdominal hypertension. Different techniques have been described in the literature and applied in the clinical setting. Methods. A porcine model was created to simulate an abdominal compartment syndrome ranging from baseline IAP to 30 mmHg. Three different measurement techniques were applied, comprising telemetric piezoresistive probes at two different sites (epigastric and pelvic) for direct pressure measurement and intragastric and intravesical probes for indirect measurement. Results. The mean difference between the invasive IAP measurements using telemetric pressure probes and the IVP measurements was -0.58 mmHg. The bias between the invasive IAP measurements and the IGP measurements was 3.8 mmHg. Compared to the realistic results of the intraperitoneal and intravesical measurements, the intragastric data showed a strong tendency towards decreased values. The hydrostatic character of the IAP was eliminated at high-pressure levels. Conclusion. We conclude that intragastric pressure measurement is potentially hazardous and might lead to inaccurately low intra-abdominal pressure values. This may result in missed diagnosis of elevated abdominal pressure or even ACS. The intravesical measurements showed the most accurate values during baseline pressure and both high-pressure plateaus.

  19. The role of each compartment in a two-compartment vertical flow reactor for ferruginous mine water treatment.

    Yim, G J; Cheong, Y W; Hong, J H; Hur, W

    2014-10-01

    A vertical flow reactor (VFR) has been suggested for remediation of ferruginous mine drainage that passes down through an accreting bed of ochre. However, a VFR has a limited operation time until the system begins to overflow. In this study, a mathematical model was developed as a part of the effort to explore the operation of a VFR, showing dynamic changes in the head differences, ochre depths, and Fe(II)/Fe(III) concentrations in the effluent flow. The analysis showed that VFR operation time extended from 148.5 days to 163 days in an equally divided and to 168.4 days in asymmetrically (0.72:0.28) divided two-compartment VFR, suggesting that an optimum compartment ratio exists that maximizes the VFR operation time. A constant head filtration in the first compartment maximized filtration efficiency and thus prolonged VFR longevity in the two-compartment VFR. Fe(II) oxidation and ochre formation should be balanced with the permeability of the ochre bed to maximize the VFR operation time and minimize the residual Fe(II) in the effluent. Accelerated Fe(II) oxidation affected the optimum ratio of the compartment area and reduced the residual Fe(II) in the effluent. The VFR operation time can be prolonged significantly from 764 days to 3620 days by increasing the rate of ochre formation, much more than by accelerating the Fe(II) oxidation. During the prolonged VFR operation, ochre formed largely in the first compartment, while overflowing mine water with reduced iron content was effectively filtered in the second compartment. These results not only provide a better understanding of VFR operation but also suggest the direction of evolution of two-compartment VFR toward a compact and highly efficient facility integrated with an aerated cascade and with automatic coagulant feeding. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Treatment of Extra — Abdominal Desmoid Tumors with Chemotherapy

    Montgomery, Corey; Emory, Cynthia; Adams, Sheila; Cohen, Jonathan; Pitcher, John David; Potter, Benjamin Kyle; Temple, H. Thomas

    2011-01-01

    Fibromatosis, or extra-abdominal desmoid tumor, is a benign disease which often has an aggressive clinical course that can be difficult to treat. We performed a retrospective review of 16 patients (12 females and four males) with a mean age of 34.2 years treated with methotrexate and vinblastine for newly diagnosed or recurrent extra-abdominal desmoid tumor. The mean age of our patient cohort was 34.2 years (range 11–70), and the mean tumor size was 11.5 cm (range 2.5–21.2 cm). The mean duration of therapy was 12 months with an average follow-up of 43 months (range 1–149 months). Fourteen of 16 patients demonstrated a clinical response to treatment. Eight of 14 patients demonstrated a radiologic decrease in tumor size. Only one patient progressed on therapy. Six patients developed recurrent symptoms after discontinuation of treatment. Chemotherapy-related symptoms including neutropenia, nausea, and vomiting were common and observed in most patients, however these side effects were mild and transient. Five patients developed peripheral neuropathy that prompted a change from vinblastine to vinorelbine during treatment. One potentially life-threatening complication (pneumocystis pneumonia) occurred which was diagnosed early and successfully treated. The use of methotrexate and vinblastine/vinorelbine in the management of fibromatosis appears to be an effective treatment with minimal treatment-related side effects

  1. Treatment of Extra — Abdominal Desmoid Tumors with Chemotherapy

    Montgomery, Corey [Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72211 (United States); Emory, Cynthia [Wake Forest School of Medicine, Medical Center Blvds, Winston-Salem, NC 27157 (United States); Adams, Sheila [Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Cedars Medical Center, 1400 NW 12th Avenue (R-12), Miami, FL 33136 (United States); Cohen, Jonathan [Division of Psychology, University of Miami Miller School of Medicine, 1695 N.W. 9th Ave. (D-29), Miami, FL 33136 (United States); Pitcher, John David [Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, 1400 NW 12th Avenue (R-12), Miami, FL 33136 (United States); Potter, Benjamin Kyle [Department of Orthopaedic Surgery, Walter Reed Army Medical Center, 6900 Georgia Avenue North West, Washington, D.C., 20307 (United States); Temple, H. Thomas [Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, 1600 N.W. 10th Avenue (R-12), Miami, FL 33136 (United States)

    2011-08-25

    Fibromatosis, or extra-abdominal desmoid tumor, is a benign disease which often has an aggressive clinical course that can be difficult to treat. We performed a retrospective review of 16 patients (12 females and four males) with a mean age of 34.2 years treated with methotrexate and vinblastine for newly diagnosed or recurrent extra-abdominal desmoid tumor. The mean age of our patient cohort was 34.2 years (range 11–70), and the mean tumor size was 11.5 cm (range 2.5–21.2 cm). The mean duration of therapy was 12 months with an average follow-up of 43 months (range 1–149 months). Fourteen of 16 patients demonstrated a clinical response to treatment. Eight of 14 patients demonstrated a radiologic decrease in tumor size. Only one patient progressed on therapy. Six patients developed recurrent symptoms after discontinuation of treatment. Chemotherapy-related symptoms including neutropenia, nausea, and vomiting were common and observed in most patients, however these side effects were mild and transient. Five patients developed peripheral neuropathy that prompted a change from vinblastine to vinorelbine during treatment. One potentially life-threatening complication (pneumocystis pneumonia) occurred which was diagnosed early and successfully treated. The use of methotrexate and vinblastine/vinorelbine in the management of fibromatosis appears to be an effective treatment with minimal treatment-related side effects.

  2. Extramedullary spinal teratoma presenting with recurrent aseptic meningitis.

    Mpayo, Lucy L; Liu, Xiao-Hong; Xu, Man; Wang, Kai; Wang, Jiao; Yang, Li

    2014-06-01

    Spinal teratomas are extremely rare; they constitute meningitis. A 7-year-old boy presented with paroxysmal abdominal pain and a history of recurrent aseptic meningitis. Kernig and Brudzinski signs were present. Lumber puncture revealed pleocytosis with no evidence of bacteria growth. Imaging of the spine revealed a cystic lesion in spinal cord at thoracic level 9-11. Endoscopic excision of the cyst was successfully performed. Surgical and histopathological findings confirmed extramedullary matured teratoma. As the symptomatic attacks of spontaneous rupture of spinal teratoma resemble presentations of Mollaret meningitis, spinal teratoma should be considered in the differential diagnosis of Mollaret meningitis. We describe a rare example of spinal teratoma causing recurrent meningitis. Spine imaging should be considered in individuals with recurrent aseptic meningitis as this promotes earlier diagnosis, more appropriate treatment, and improved neurological outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... to evaluate the: appendix stomach/ pylorus liver gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, appendicitis is the most common reason for emergency ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... procedure work? How is the procedure performed? What will my child experience during and after the procedure? Who interprets the results and how do we get them? What are the benefits vs. risks? What are the limitations of Abdominal ...

  5. Dehydration related abdominal pain (drap)

    Shah, S.I.; Aurangzeb; Khan, I.; Bhatti, A.M.; Khan, A.A.

    2004-01-01

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

  6. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... particularly valuable for evaluating abdominal, pelvic or scrotal pain in young children. It is also valuable for evaluating the brain, spinal cord and hip joints in newborns and infants. Risks For standard diagnostic ultrasound , there are no known harmful effects on ...

  7. Chest complication after abdominal surgery

    Koh, B. H.; Choi, J. Y.; Hahm, C. K.; Kang, S. R.

    1981-01-01

    In spite of many advances in medicine, anesthetic technique and surgical managements, pulmonary problems are the most frequent postoperative complications, particularly after abdominal surgery. As postoperative pulmonary complications, atelectasis, pleural effusion, pneumonia, chronic bronchitis and lung abscess can be occurred. This study include evaluation of chest films of 2006 patients (927 male, 1079 female), who had been operated abdominal surgery from Jan. 1979 to June, 1980 in the Hanyang university hospital. The results were as follows: 1. 70 cases out of total 2006 cases (3.5%) developed postoperative chest complications, 51 cases (5.5%) in male, 19 cases (1.8%) in female. 2. The complication rate was increased according to the increase of age. The incidence of the postoperative complications over 40 years of age was higher than the overall average complications rate. 3. The most common postoperative pulmonary complication was pleural effusion, next pneumonia, atelectasis and pulmonary edema respectively. 4. The complication rate of the group of upper abdominal surgery is much higher than the group of lower abdominal surgery. 5. Complication rate was increased according to increase of the duration of operation. 6. There were significant correlations between the operation site and side of the complicated hemithorax

  8. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... is Abdominal Ultrasound Imaging? What are some common uses of the procedure? How should we prepare for an ultrasound exam? What does the ultrasound equipment look like? How does the procedure work? How is the procedure performed? What will my ...

  9. Original Research Abdominal myomectomy: A retrospective review ...

    Abdominal myomectomy and outcome in Ilorin, Nigeria 37. Malawi Medical Journal 29 (1): ... rate of 3.34% has been reported for Maiduguri, northeastern. Nigeria.4 Abdominal ... of Nigeria.6. Infertility secondary to uterine fibroid is one of the.

  10. Staged abdominal closure with intramuscular tissue expanders and modified components separation technique of a giant incisional hernia after repair of a ruptured omphalocele

    Yukihiro Tatekawa

    2016-07-01

    Full Text Available In patients with omphalocele, several different techniques are performed for repair of the abdominal wall defect. We present the case of a staged abdominal closure of a giant incisional hernia after repair of a ruptured omphalocele. At birth, skin flap coverage associated with silo formation occurred, but the abdominal wall defect remained, resulting in a giant abdominal hernia. To expand the layers of the abdominal wall, tissue expanders were placed between the bilateral internal oblique and transverses abdominis muscles. Postoperatively, a modified components separation technique was performed. The abdominal wall was closed in the midline. Upon closure of the skin in the midline, bilateral relaxing incisions were performed, covering the remaining defect with artificial dermis. At the age of one year and 7 months, the patient had no recurrent incisional hernia nor any wound complications.

  11. Hyperhomocysteinemia in Recurrent Miscarriage

    Gaber, Kh.R.; Farag, M.K.; Soliman, S.Et.; Abd Al-Kaderm, M.A.

    2008-01-01

    Objective: An elevated total plasma homocysteine level has been suggested as a possible risk factor in women suffering from recurrent pregnancy loss. The current study was undertaken to assess the association between homocysteine, folate, cobalamin (vitamin B12) and the risk of recurrent pregnancy loss. Design: Case . control study Materials and Methods: The study included 57 non-pregnant Egyptian women. They were classified according to their obstetric history into 2 groups: 32 cases with at least two consecutive miscarriages (Study group), and 25 cases with normal obstetric history (Control group). All cases were tested for plasma total homocysteine, serum folate and cobalamin (vitamin B12). Results: The fasting total homocysteine was significantly higher in the study group as compared to the control group. While the median concentrations for the vitamins studied were significantly lower in women of the study group as compared to the controls. Elevated homocysteine and reduced vitamin B12 can be considered risk factors for recurrent miscarriage with odds ratio (OR) and 95% confidence intervals (95% CI) of 1.839 (1.286, 2.63) and 1.993 (1.346, 2.951) respectively in the group of recurrent miscarriages. The OR (95% CI) in the study population for low serum folate concentrations was 1.23 (0.776, 2.256). Conclusion: Elevated homocysteine and reduced serum vitamin B12 are risk factors for recurrent miscarriage. Low serum folate did not seem a risk factor for recurrent miscarriage. Testing for homocysteine levels in women suffering from unexplained recurrent miscarriage and pre-conceptional supplementation with vitamin B12 might be beneficial to improve pregnancy outcome

  12. Hyperhomocysteinemia in Recurrent Miscarriage

    Gaber, Kh R; Farag, M K [Prenatal Diagnosis and Fetal Medicine Department, National Research Centre, Dokki, Giza (Egypt); Soliman, S Et [Radioisotope Department, Nuclear Research Centre, Atomic Energy Authority, Cairo (Egypt); Abd Al-Kaderm, M A [Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo (Egypt)

    2008-07-01

    Objective: An elevated total plasma homocysteine level has been suggested as a possible risk factor in women suffering from recurrent pregnancy loss. The current study was undertaken to assess the association between homocysteine, folate, cobalamin (vitamin B12) and the risk of recurrent pregnancy loss. Design: Case . control study Materials and Methods: The study included 57 non-pregnant Egyptian women. They were classified according to their obstetric history into 2 groups: 32 cases with at least two consecutive miscarriages (Study group), and 25 cases with normal obstetric history (Control group). All cases were tested for plasma total homocysteine, serum folate and cobalamin (vitamin B12). Results: The fasting total homocysteine was significantly higher in the study group as compared to the control group. While the median concentrations for the vitamins studied were significantly lower in women of the study group as compared to the controls. Elevated homocysteine and reduced vitamin B12 can be considered risk factors for recurrent miscarriage with odds ratio (OR) and 95% confidence intervals (95% CI) of 1.839 (1.286, 2.63) and 1.993 (1.346, 2.951) respectively in the group of recurrent miscarriages. The OR (95% CI) in the study population for low serum folate concentrations was 1.23 (0.776, 2.256). Conclusion: Elevated homocysteine and reduced serum vitamin B12 are risk factors for recurrent miscarriage. Low serum folate did not seem a risk factor for recurrent miscarriage. Testing for homocysteine levels in women suffering from unexplained recurrent miscarriage and pre-conceptional supplementation with vitamin B12 might be beneficial to improve pregnancy outcome.

  13. 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

    Rutten, Juliette M. T. M.; Vlieger, Arine M.; Frankenhuis, Carla; George, Elvira K.; Groeneweg, Michael; Norbruis, Obbe F.; Tjon A ten, Walther; van Wering, Herbert; Dijkgraaf, Marcel G. W.; Merkus, Maruschka P.; Benninga, Marc A.

    2014-01-01

    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) performed by a therapist

  14. Postoperative evaluation of renal cell carcinoma in the abdominal computed tomography

    Kurihara, Noriko; Tazawa, Satoru; Suzuki, Yasuyoshi; Kato, Masakazu

    1993-01-01

    Two hundred one abdominal CT scans were performed in 93 patients who had undergone previous nephrectomy for renal cell carcinoma. Three had local recurrence and nine had metastatic lesions. Local recurrence and metastatic lesions were detected from 7 months to 6 years and 4 months after nephrectomy (median 2 years and 9 months). Local recurrent lesions were detected as masses in the vacant renal fossa. Metastatic lesions of the abdomen were seen in adrenal gland, liver, contralateral kidney, bone, etc. Administration of oral contrast material was useful to differentiate these recurrent lesions from intestine. It was important to fully understand the anatomical change after nephrectomy, and ultrasonography might be especially helpful for evaluating the liver and contralateral kidney. (author)

  15. Recurrences of Bell's palsy.

    Cirpaciu, D; Goanta, C M; Cirpaciu, M D

    2014-01-01

    Bell's palsy in known as the most common cause of facial paralysis, determined by the acute onset of lower motor neuron weakness of the facial nerve with no detectable cause. With a lifetime risk of 1 in 60 and an annual incidence of 11-40/100,000 population, the condition resolves completely in around 71% of the untreated cases. Clinical trials performed for Bell's palsy have reported some recurrences, ipsilateral or contralateral to the side affected in the primary episode of facial palsy. Only few data are found in the literature. Melkersson-Rosenthal is a rare neuromucocutaneous syndrome characterized by recurrent facial paralysis, fissured tongue (lingua plicata), orofacial edema. We attempted to analyze some clinical and epidemiologic aspects of recurrent idiopathic palsy, and to develop relevant correlations between the existing data in literature and those obtained in this study. This is a retrospective study carried out on a 10-years period for adults and a five-year period for children. A number of 185 patients aged between 4 and 70 years old were analyzed. 136 of them were adults and 49 were children. 22 of 185 patients with Bell's palsy (12%) had a recurrent partial or complete facial paralysis with one to six episodes of palsy. From this group of 22 cases, 5 patients were diagnosed with Melkersson-Rosenthal syndrome. The patients' age was between 4 and 70 years old, with a medium age of 27,6 years. In the group studied, fifteen patients, meaning 68%, were women and seven were men. The majority of patients in our group with more than two facial palsy episodes had at least one episode on the contralateral side. Our study found a significant incidence of recurrences of idiopathic facial palsy. Recurrent idiopathic facial palsy and Melkersson-Rosenthal syndrome is diagnosed more often in young females. Recurrence is more likely to occur in the first two years from the onset, which leads to the conclusion that we should have a follow up of patients

  16. Internal Mammary Vessels’ Impact on Abdominal Skin Perfusion in Free Abdominal Flap Breast Reconstruction

    Solveig Nergård, MD

    2017-12-01

    Conclusions:. Using the IMV in free abdominal flap breast reconstruction had a significant effect on abdominal skin perfusion and may contribute to abdominal wound healing problems. The reperfusion of the abdominal skin was a dynamic process showing an increase in perfusion in the affected areas during the postoperative days.

  17. Direct and Recurrent Inguinal Hernias are Associated with Ventral Hernia Repair

    Henriksen, Nadia A; Sorensen, Lars T; Bay-Nielsen, Morten

    2013-01-01

    A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim...

  18. Membrane order in the plasma membrane and endocytic recycling compartment.

    Iaea, David B; Maxfield, Frederick R

    2017-01-01

    The cholesterol content of membranes plays an important role in organizing membranes for signal transduction and protein trafficking as well as in modulating the biophysical properties of membranes. While the properties of model or isolated membranes have been extensively studied, there has been little evaluation of internal membranes in living cells. Here, we use a Nile Red based probe, NR12S, and ratiometric live cell imaging, to analyze the membrane order of the plasma membrane and endocytic recycling compartment. We find that after a brief incubation to allow endocytosis, NR12S is distributed between the plasma membrane and the endocytic recycling compartment. The NR12S reports that the endocytic recycling compartment is more highly ordered than the plasma membrane. We also find that the plasma membrane and the endocytic recycling compartment are differentially affected by altering cellular cholesterol levels. The membrane order of the plasma membrane, but not the endocytic recycling compartment, is altered significantly when cellular cholesterol content is increased or decreased by 20%. These results demonstrate that changes in cellular cholesterol differentially alter membrane order within different organelles.

  19. Measurement of compartment elasticity using pressure related ultrasound: a method to identify patients with potential compartment syndrome.

    Sellei, R M; Hingmann, S J; Kobbe, P; Weber, C; Grice, J E; Zimmerman, F; Jeromin, S; Gansslen, A; Hildebrand, F; Pape, H C

    2015-01-01

    PURPOSE OF THE STUDY Decision-making in treatment of an acute compartment syndrome is based on clinical assessment, supported by invasive monitoring. Thus, evolving compartment syndrome may require repeated pressure measurements. In suspected cases of potential compartment syndromes clinical assessment alone seems to be unreliable. The objective of this study was to investigate the feasibility of a non-invasive application estimating whole compartmental elasticity by ultrasound, which may improve accuracy of diagnostics. MATERIAL AND METHODS In an in-vitro model, using an artificial container simulating dimensions of the human anterior tibial compartment, intracompartmental pressures (p) were raised subsequently up to 80 mm Hg by infusion of saline solution. The compartmental depth (mm) in the cross-section view was measured before and after manual probe compression (100 mm Hg) upon the surface resulting in a linear compartmental displacement (Δd). This was repeated at rising compartmental pressures. The resulting displacements were related to the corresponding intra-compartmental pressures simulated in our model. A hypothesized relationship between pressures related compartmental displacement and the elasticity at elevated compartment pressures was investigated. RESULTS With rising compartmental pressures, a non-linear, reciprocal proportional relation between the displacement (mm) and the intra-compartmental pressure (mm Hg) occurred. The Pearson's coefficient showed a high correlation (r2 = -0.960). The intraobserver reliability value kappa resulted in a statistically high reliability (κ = 0.840). The inter-observer value indicated a fair reliability (κ = 0.640). CONCLUSIONS Our model reveals that a strong correlation between compartmental strain displacements assessed by ultrasound and the intra-compartmental pressure changes occurs. Further studies are required to prove whether this assessment is transferable to human muscle tissue. Determining the complete

  20. Surgical treatment of pelvic organ prolapse: a historical review with emphasis on the anterior compartment.

    Lensen, E J M; Withagen, M I J; Kluivers, K B; Milani, A L; Vierhout, M E

    2013-10-01

    The objective of this work was to collect and summarize a detailed historical review of the surgical treatment of pelvic organ prolapse (POP) in which we specifically focused on the anterior compartment. A literature search in English, Dutch, and German was carried out using the keywords pelvic organ prolapse, anterior colporrhaphy, cystocele, and interposition operations in several databases (e.g., PubMed and HathiTrust Digital Library). Other relevant journal and textbook articles were found by retrieving references cited in previous articles and textbooks. Probably the first explanation of the treatment of POP dates from 1500 B.C. The Egyptians gave a description to "falling of the womb" in the Kahun Papyrus. More than a millennium later, Euryphon, a contemporary of Hippocrates (400 B.C.) described some interesting therapeutic options, from succussion (turning a women upside down for several minutes) to irrigating the displaced uterus with wine. A wide range of techniques has been attempted to repair the prolapsing anterior vaginal wall. By 1866, Sim had already performed a series of operations very similar to a modern anterior repair. The first reviews about the abdominal approach to correcting a cystocele were in 1890. The first description of using mesh to cystoceles was the use of tantalum mesh in 1955. In 1970, the first report of collagen mesh in urogynecology was described. Nowadays, robot-assisted surgery and cell-based tissue engineering are the latest interventions. Many surgeons have tried to find the ideal surgical therapy for anterior compartment prolapse, but to date, this has not been achieved.

  1. Recurrent parotitis in children

    Bhattarai M

    2006-01-01

    Full Text Available Recurrent parotitis is an uncommon condition in children. Its etiological factors have not been proved till date although causes due to genetic inheritance, local autoimmune manifestation, allergy, viral infection and immunodeficiency have been suggested. The exact management of this disorder is not yet standardized, but a conservative approach is preferred and all affected children should be screened for Sjogren′s syndrome and immune deficiency including human immunodeficiency virus. We report a 12 years female child who presented with 12 episodes of non-painful recurrent swellings of the bilateral parotid gland in the past 3 years.

  2. Recurrent atrial myxoma.

    Macarie, C; Stoica, E; Chioncel, O; Carp, A; Gherghiceanu, D; Stiru, O; Zarma, L; Herlea, V

    2004-01-01

    We have chosen this case of sporadic atrial myxoma for our presentation because it had a particular evolution, with recurrence at 8 years after surgical excision (echocardiography was performed every year) and a particular diagnostic means - at echocardiographic follow-up, the patient being asymptomatic. This presentation, together with a review of literature included in the article, emphasizes the importance of a careful postoperative follow-up of the patients and the existence of some particular aspects of the evolution and symptomatology of recurrent atrial myxoma.

  3. Exercise Induced Rhabdomyolysis with Compartment Syndrome and Renal Failure

    Mary Colleen Bhalla

    2014-01-01

    Full Text Available Exertional rhabdomyolysis is sequela that is occasionally seen after strenuous exercise. The progression to compartment syndrome or renal failure is a rare complication that requires prompt recognition and treatment to prevent morbidity (Giannoglou et al. 2007. We present a case of a 22-year-old college football player who presented to the emergency department (ED after a typical leg workout as part of his weight conditioning. He was found to have rhabdomyolysis with evidence of renal insufficiency. His condition progressed to bilateral compartment syndrome and renal failure requiring dialysis. After bilateral fasciotomies were performed he had resolution of his compartment syndrome. He continued to be dialysis dependent and had no return of his renal function at discharge 12 days after admission.

  4. Hepatic computed tomography perfusion. Comparison of maximum slope and dual-input single-compartment methods

    Kanda, Tomonori; Yoshikawa, Takeshi; Ohno, Yoshiharu; Kanata, Naoki; Koyama, Hisanobu; Nogami, Munenobu; Takenaka, Daisuke; Sugimura, Kazuro

    2010-01-01

    The aim of the study was to compare two analytical methods-maximum slope (MS) and the dualinput single-compartment model (CM)-in computed tomography (CT) measurements of hepatic perfusion and to assess the effects of extrahepatic systemic factors. A total of 109 patients underwent hepatic CT perfusion. The scans were conducted at the hepatic hilum 7-77 s after administration of contrast material. Hepatic arterial perfusion (HAP) and portal perfusion (HPP) (ml/min/100 ml) and the arterial perfusion fraction (APF, %) were calculated with the two methods, followed by correlation assessment. Partial correlation analysis was used to assess the effects on hepatic perfusion values by various factors, including age, sex, risk of cardiovascular disease, compensation for respiratory misregistration, arrival time of contrast material at the abdominal aorta, transit time from abdominal aorta to hepatic parenchyma, and liver dysfunction. The mean HAPs, HPPs, and APFs were, respectively, 31.4, 104.2, and 23.9 for MS and 27.1, 141.3, and 22.1 for CM. HAP and APF showed significant (P<0.0001) and moderate correlation (γ=0.417 and 0.548) and HPP showed poor correlation (γ=0.172) between the two methods. While MS showed weak correlations (γ=-0.39 to 0.34; P<0.001 to <0.02) between multiple extrahepatic factors and perfusion values, CM showed weak correlation only between the patients' sex and HAP (γ=0.31, P=0.001). Hepatic perfusion values estimated by the two methods are not interchangeable. CM is less susceptible to extrahepatic systemic factors. (author)

  5. Acupuncture Treatment of Abdominal Pain

    胡金生

    2002-01-01

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

  6. Computed tomography, after abdominal surgery

    Vogel, H.; Toedt, H.C.; Hamburg Univ.

    1985-01-01

    The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which fascilated the differentialdiagnosis to tumorrecurrency. The changes of the roentgenmorphology were not so abvious after gastro-intestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolusinjection. (orig.) [de

  7. Defectos de la pared abdominal

    Adis L. Peña Cedeño

    2004-03-01

    Full Text Available Se realizó un estudio de los fetos con malformaciones congénitas, dadas por defecto de la pared abdominal (DPA, nacidos en el Hospital Universitario Ginecoobstétrico de Guanabacoa durante los años 1984 al 2000, para determinar la frecuencia de los distintos tipos de defectos de la pared abdominal y las malformaciones asociadas a éstas. Se revisaron los protocolos de necropsias e historias clínicas en este período y se obtuvieron 25 casos con DPA. La malformación más frecuente fue el onfalocele con 14 casos, seguido de la gastrosquisis con 6 casos. Se hallaron malformaciones asociadas en el 68 % de los casos, y se comprobó la efectividad del Programa Nacional de Malformaciones Congénitas, pues en el 80 % de las pacientes se interrumpió precozmente el embarazo.A study of the fetuses with congenital malformations due to defect of the abdominal wall (AWD that were born at the Gynecoobstetric Teaching Hospital of Guanabacoa from 1984 to 2000 was conducted aimed at determining the frequency of the different types of defects of the abdominal wall and the malformations associated with them. The protocosl of necropsies and medical histories corresponding to this period were reviewed and 25 cases with AWD were detected. The most common malformation was omphalocele with 14 cases, followed by gastrosquisis with 6 cases. Associated malformations were found in 68 % of the cases and it was proved the effectiveness of the National Program of Congenital Malformations, since pregnancy was interrupted early in 80 % of the patients.

  8. A microvascular compartment model validated using 11C-methylglucose liver PET in pigs

    Munk, Ole L.; Keiding, Susanne; Baker, Charles; Bass, Ludvik

    2018-01-01

    The standard compartment model (CM) is widely used to analyse dynamic PET data. The CM is fitted to time-activity curves to estimate rate constants that describe the transport of a tracer between well-mixed compartments. The aim of this study was to develop and validate a more realistic microvascular compartment model (MCM) that includes capillary tracer concentration gradients, backflux from cells into the perfused capillaries and multiple re-uptakes during the passage through a capillary. The MCM incorporates only parameters with clear physiological meaning, it is easy to implement, and it does not require numerical solution. We compared the MCM and CM for the analysis of 3 min dynamic PET data of pig livers (N  =  5) following injection of 11C-methylglucose. During PET scans, the tracer concentrations in blood were measured in the abdominal aorta, portal vein and liver vein by manual sampling. We found that the MCM outperformed the CM and that dynamic PET data include information which cannot be extracted using standard CM. The MCM fitted dynamic PET data better than the CM (Akaike values were 46  ±  4 for best MCM fits, and 82  ±  8 for best CM fits; mean  ±  standard deviation) and extracted physiologically reasonable parameter estimates such as blood perfusion that were in agreement with independent measurements. The difference between model-independent perfusion estimates and the best MCM perfusion estimates was  -0.01  ±  0.05 ml/ml/min, whereas the difference was 0.30  ±  0.13 ml/ml/min using the CM. In addition, the MCM predicted the time course of concentrations in the liver vein, a prediction fundamentally unobtainable using the CM as it does not return tracer backflux from cells to capillary blood. The results demonstrate the benefit of using models that include more physiology and that models including concentration gradients should be preferred when analysing the blood-cell exchange of

  9. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias.

    Birindelli, Arianna

    2017-01-01

    Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.

  10. Repair of Postoperative Abdominal Hernia in a Child with Congenital Omphalocele Using Porcine Dermal Matrix

    V. Lambropoulos

    2016-01-01

    Full Text Available Introduction. Incisional hernias are a common complication appearing after abdominal wall defects reconstruction, with omphalocele and gastroschisis being the most common etiologies in children. Abdominal closure of these defects represents a real challenge for pediatric surgeons with many surgical techniques and various prosthetic materials being used for this purpose. Case Report. We present a case of repair of a postoperative ventral hernia occurring after congenital omphalocele reconstruction in a three-and-a-half-year-old child using an acellular, sterile, porcine dermal mesh. Conclusion. Non-cross-linked acellular porcine dermal matrix is an appropriate mesh used for the reconstruction of abdominal wall defects and their postoperative complications like large ventral hernias with success and preventing their recurrence.

  11. Hernia Following Blunt Abdominal Trauma

    N Aghaie

    2009-10-01

    Full Text Available Traumatic abdominal wall hernia is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed. Traumatic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck blunt trauma is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein. Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the abdominal wall defect. The colon was reduced in the abdomen and repair of abdominal hernia was done. The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed.

  12. Mesh erosion after abdominal sacrocolpopexy.

    Kohli, N; Walsh, P M; Roat, T W; Karram, M M

    1998-12-01

    To report our experience with erosion of permanent suture or mesh material after abdominal sacrocolpopexy. A retrospective chart review was performed to identify patients who underwent sacrocolpopexy by the same surgeon over 8 years. Demographic data, operative notes, hospital records, and office charts were reviewed after sacrocolpopexy. Patients with erosion of either suture or mesh were treated initially with conservative therapy followed by surgical intervention as required. Fifty-seven patients underwent sacrocolpopexy using synthetic mesh during the study period. The mean (range) postoperative follow-up was 19.9 (1.3-50) months. Seven patients (12%) had erosions after abdominal sacrocolpopexy with two suture erosions and five mesh erosions. Patients with suture erosion were asymptomatic compared with patients with mesh erosion, who presented with vaginal bleeding or discharge. The mean (+/-standard deviation) time to erosion was 14.0+/-7.7 (range 4-24) months. Both patients with suture erosion were treated conservatively with estrogen cream. All five patients with mesh erosion required transvaginal removal of the mesh. Mesh erosion can follow abdominal sacrocolpopexy over a long time, and usually presents as vaginal bleeding or discharge. Although patients with suture erosion can be managed successfully with conservative treatment, patients with mesh erosion require surgical intervention. Transvaginal removal of the mesh with vaginal advancement appears to be an effective treatment in patients failing conservative management.

  13. Appendicitis following blunt abdominal trauma.

    Cobb, Travis

    2017-09-01

    Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination. These include direct compression/crush injury, shearing injury, or from indirect obstruction of the appendiceal lumen by an ileocecal hematoma or traumatic impaction of stool into the appendix. Presentation typically mirrors that of non-traumatic appendicitis with nausea, anorexia, fever, and right lower quadrant abdominal tenderness and/or peritonitis. Evaluation for traumatic appendicitis requires a careful history and physical exam. Imaging with ultrasound or computed tomography is recommended if the history and physical do not reveal an acute surgical indication. Treatment includes intravenous antibiotics and surgical consultation for appendectomy. This case highlights a patient who developed acute appendicitis following blunt trauma to the abdomen sustained during a motor vehicle accident. Appendicitis must be considered as part of the differential diagnosis in any patient who presents to the ED with abdominal pain, including those whose pain begins after sustaining blunt trauma to the abdomen. Because appendicitis following trauma is uncommon, timely diagnosis requires a high index of suspicion. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Methods of abdominal wall expansion for repair of incisional herniae: a systematic review.

    Alam, N N; Narang, S K; Pathak, S; Daniels, I R; Smart, N J

    2016-04-01

    To systematically review the available literature regarding methods for abdominal wall expansion and compare the outcome of primary fascial closure rates. A systematic search of Pubmed and Embase databases was conducted using the search terms "Abdominal wall hernia", "ventral hernia", "midline hernia", "Botulinum toxin", "botox", "dysport", "progressive preoperative pneumoperitoneum", and "tissue expanders". Study quality was assessed using the Methodological Index for Non-Randomised Studies. 21 of the 105 studies identified met the inclusion criteria. Progressive preoperative pneumoperitoneum (PPP) was performed in 269 patients across 15 studies with primary fascial closure being achieved in 226 (84%). 16 patients had a recurrence (7.2%) and the complication rate was 12% with 2 reported mortalities. There were 4 studies with 14 patients in total undergoing abdominal wall expansion using tissue expanders with a fascial closure rate of 92.9% (n = 13). A recurrence rate of 10.0% (n = 1) was reported with 1 complication and no mortalities. Follow up ranged from 3 to 36 months across the studies. There were 2 studies reporting the use of botulinum toxin with 29 patients in total. A primary fascial closure rate of 100% (n = 29) was demonstrated although a combination of techniques including component separation and Rives-Stoppa repair were used. There were no reported complications related to the use of Botulinum Toxin. However, the short-term follow up in many cases and the lack of routine radiological assessment for recurrence suggests that the recurrence rate has been underestimated. PPP, tissue expanders and Botulinum toxin are safe and feasible methods for abdominal wall expansion prior to incisional hernia repair. In combination with existing techniques for repair, these methods may help provide the crucial extra tissue mobility required to achieve primary closure.

  15. Lung Cancer Indicators Recurrence

    This study describes prognostic factors for lung cancer spread and recurrence, as well as subsequent risk of death from the disease. The investigators observed that regardless of cancer stage, grade, or type of lung cancer, patients in the study were more

  16. Recurrent diabetic ketoacidosis

    Skinner, T. Chas

    2002-01-01

    Longitudinal studies indicate that 20% of paediatric patients account for 80% of all admissions for diabetic ketoacidosis (DKA). The frequency of DKA peaks during adolescence and, although individuals generally go into remission, they may continue to have bouts of recurrent DKA in adulthood. The ...

  17. Recurrent infantile digital fibromatosis

    We present a case of an 8-year-old-boy with recurrent infantile digital fibromatosis (IDF) who presented with new ... Keywords: fibrous tumors, inclusion body fibromatosis, infantile digital fibromatosis, spindle cells, Reye tumor .... watch-and-wait strategy for patients with histologically confirmed IDF nodules that do not cause ...

  18. On Solving Linear Recurrences

    Dobbs, David E.

    2013-01-01

    A direct method is given for solving first-order linear recurrences with constant coefficients. The limiting value of that solution is studied as "n to infinity." This classroom note could serve as enrichment material for the typical introductory course on discrete mathematics that follows a calculus course.

  19. Upper abdominal malignancies (not including esophagus)

    Rich, Tyvin A.

    1996-01-01

    combined with chemotherapy in patients with unresectable disease, and that radiation therapy and chemotherapy is of value as an adjuvant therapy in patients who have had a potentially curative surgical resection. There is relatively little information on the treatment of cancers of the biliary tract with radiation therapy. However, the existing data on recurrence patterns and therapy will be reviewed. The use of brachytherapy for patients with biliary obstruction will be discussed. In most tumors of the GI tract, the combination of radiation therapy with 5-FU chemotherapy seems to be more effective than radiation therapy alone. Newer information suggests that modulators of 5-FU effect such as leucovorin, or altered modes of administration such as continuous infusion, may be beneficial. These issues will be discussed as they relate to the upper abdominal malignancies

  20. Case of a sigmoid colon cancer with metachronous metastases to the mesorectum and the abdominal wall

    Hadjimarcou Andreas

    2010-03-01

    Full Text Available Abstract Backround Sigmoid colon cancer metachronous metastases commonly occur in the liver and lungs with sporadic reports also to the spleen, stomach, thyroid gland, abdominal wall and upper urinary tract. This is a rare case of metachronous metastases invading the mesorectum and the abdominal wall. Case presentation A 72-year-old female underwent sigmoidectomy for stage I (T2N0 M0 sigmoid colon cancer in May 2008. In June 2009, an abdominal computed tomography scan revealed a tumor 2 cm in size at the lower anterior mesorectum and a second mass 2 cm in size at the anterior abdominal wall midline. Total colonoscopy showed no mucosal lesion. The serum carcinoembryonic antigen level was normal. A biopsy of the mesorectum tumor showed similar histologic characteristics with the primary tumor. Since no other site of recurrence was identified, an abdominoperineal resection was attempted. During the operation and after the removal of the incision recurrence, sinus bradycardia and signs of myocardial ischemia were noticed. A loop transverse colostomy was immediately perfomed and the operation was terminated. Postoperative cardiologic examination revealed an acute myocardium infract. Chemo-radiation of the mesorectum tumor and re-evaluation for surgical excision was decided. Conclusion Metachronous metastasis of the mesorectum from sigmoid colon cancer is extremely rare. Although patterns of lymphatic spread from rectal cancer to sigmoid colon have recently been demonstrated, there is no evidence of metachronous mesorectum invasion from sigmoid colon cancer. This could be the issue for future trials.

  1. Percutaneous Liver Biopsy after Living Donor Liver Transplantation Resulting in Fulminant Hepatic Failure: The First Reported Case of Hepatic Compartment Syndrome

    Nicholas N. Nissen

    2010-01-01

    Full Text Available A 28-year-old female who underwent live donor liver transplantation 3 years prior presented after percutaneous liver biopsy with abdominal and shoulder pain, nausea, vomiting, and elevated liver enzymes. Computed tomography (CT showed an intrahepatic and subcapsular hematoma. There was a progressive increase in liver enzymes, bilirubin, and INR and a decline in hemoglobin. Subsequent CT imaging revealed flattening of the portal vein consistent with compression by the enlarging hematoma. Liver failure ensued and the patient required urgent retransplantation. The explant demonstrated ischemic necrosis of greater than 90% of the liver parenchyma. We report this case of “Hepatic Compartment Syndrome” leading to fulminant hepatic failure.

  2. Well-leg compartment syndrome after gynecological laparoscopic surgery

    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...

  3. Compartment specific importance of glutathione during abiotic and biotic stress

    Bernd eZechmann

    2014-10-01

    Full Text Available The tripeptide thiol glutathione (γ-L-glutamyl-L-cysteinyl-glycine is the most important sulfur containing antioxidant in plants and essential for plant defense against abiotic and biotic stress conditions. It is involved in the detoxification of reactive oxygen species, redox signaling, the modulation of defense gene expression and important for the regulation of enzymatic activities. Even though changes in glutathione contents are well documented in plants and its roles in plant defense are well established, still too little is known about its compartment specific importance during abiotic and biotic stress conditions. Due to technical advances in the visualization of glutathione and the redox state of plants through microscopical methods some progress was made in the last few years in studying the importance of subcellular glutathione contents during stress conditions in plants. This review summarizes the data available on compartment specific importance of glutathione in the protection against abiotic and biotic stress conditions such as high light stress, exposure to cadmium, drought, and pathogen attack (Pseudomonas, Botrytis, Tobacco Mosaic Virus. The data will be discussed in connection with the subcellular accumulation of ROS during these conditions and glutathione synthesis which are both highly compartment specific (e.g. glutathione synthesis takes place in chloroplasts and the cytosol. Thus this review will reveal the compartment specific importance of glutathione during abiotic and biotic stress conditions.

  4. Talofibular compartment of the ankle joint after recent ankle sprain

    Lindstrand, A.; Mortensson, W.; Norman, O.

    1978-01-01

    The validity of predicting the condition of the anterior talofibular ligament from the shape of the lateral compartment of the ankle joint was investigated in patients with recent ankle sprain. The diagnostic value of the method was found to be restricted. (Auth.)

  5. Volume of the effect compartment in simulations of neuromuscular block

    Nigrovic, Vladimir; Proost, Johannes H.; Amann, Anton; Bhatt, Shashi B.

    2005-01-01

    Background: The study examines the role of the volume of the effect compartment in simulations of neuromuscular block (NMB) produced by nondepolarizing muscle relaxants. Methods: The molar amount of the postsynaptic receptors at the motor end plates in muscle was assumed constant; the apparent

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

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

    2003-01-01

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

  7. Surgical treatment for ~brain compartment syndrome' in children ...

    Objectives. Traumatic brain injury accounts for a high percentage of deaths in children. Raised intracranial pressure (ICP) due to brain swelling within the closed compartment of the skull leads to death or severe neurological disability if not effectively treated. We report our experience with 12 children who presented with ...

  8. The anammoxosome: an intracytoplasmic compartment in anammox bacteria

    Niftrik, L.A.M.P. van; Fuerst, J.A.; Damste, J.S.S.; Kuenen, J.G.; Jetten, M.S.M.; Strous, M.

    2004-01-01

    Anammox bacteria belong to the phylum Planctomycetes and perform anaerobic ammonium oxidation (anammox); they oxidize ammonium with nitrite as the electron acceptor to yield dinitrogen gas. The anammox reaction takes place inside the anammoxosome: an intracytoplasmic compartment bounded by a single

  9. The anammoxosome : An intracytoplasmic compartment in anammox bacteria

    Sinninghe Damsté, J.S.; Niftrik, L.A. van; Fuerst, J.A.; Kuenen, J.G.; Jetten, M.S.M.; Strous, M.

    2004-01-01

    Anammox bacteria belong to the phylum Planctomycetes and perform anaerobic ammonium oxidation (anammox); they oxidize ammonium with nitrite as the electron acceptor to yield dinitrogen gas. The anammox reaction takes place inside the anammoxosome: an intracytoplasmic compartment bounded by a single

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

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

    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

  11. Two-Compartment Pharmacokinetic Models for Chemical Engineers

    Kanneganti, Kumud; Simon, Laurent

    2011-01-01

    The transport of potassium permanganate between two continuous-stirred vessels was investigated to help chemical and biomedical engineering students understand two-compartment pharmacokinetic models. Concepts of modeling, mass balance, parameter estimation and Laplace transform were applied to the two-unit process. A good agreement was achieved…

  12. 14 CFR 121.314 - Cargo and baggage compartments.

    2010-01-01

    ...: (a) Each Class C or Class D compartment, as defined in § 25.857 of this Chapter in effect on June 16, 1986 (see Appendix L to this part), that is greater than 200 cubic feet in volume must have ceiling and sidewall liner panels which are constructed of: (1) Glass fiber reinforced resin; (2) Materials which meet...

  13. Ward Round - Late Presentation of Acute Compartment Syndrome in ...

    following the course of ibuprofen mentioned. Twelve days after admission he started to complain of increasing pain and tightness in his left thigh. Sensation and motor function. Ward Round - Late Presentation of Acute. Compartment Syndrome in the Thigh. University of Malawi, College of Medicine, Department of Surgery,.

  14. Laparotomy during endovascular repair of ruptured abdominal aortic aneurysms increases mortality.

    Adkar, Shaunak S; Turley, Ryan S; Benrashid, Ehsan; Cox, Mitchell W; Mureebe, Leila; Shortell, Cynthia K

    2017-02-01

    Subset analyses from small case series suggest patients requiring laparotomy during endovascular repair of ruptured abdominal aortic aneurysms (REVAR) have worse survival than those undergoing REVAR without laparotomy. Most concomitant laparotomies are performed for abdominal compartment syndrome. This study used data from the American College of Surgeons National Surgical Quality Improvement Program to determine whether the need for laparotomy during REVAR is associated with increased mortality. Data were obtained from the 2005 to 2013 National Surgical Quality Improvement Program participant user files based on Current Procedural Terminology (American Medical Association, Chicago, Ill) and International Classification of Diseases-9 Edition coding. Patient and procedure-related characteristics and 30-day postoperative outcomes were compared using Pearson χ 2 tests for categoric variables and Wilcoxon rank sum tests for continuous variables. A backward-stepwise multivariable logistic regression model was used to identify patient- and procedure-related factors associated with increased death after REVAR. We identified 1241 patients who underwent REVAR, and 91 (7.3%) required concomitant laparotomy. The 30-day mortality was 60% in the laparotomy group and 21% in the standard REVAR group (P < .001). The major complication rate was also higher in the laparotomy group (88% vs 63%; P < .001). Multivariable analysis showed laparotomy was strongly associated with 30-day mortality (odds ratio, 5.91; 95% confidence interval, 3.62-9.62; P < .001). Laparotomy during REVAR is a commonly used technique for the management of elevated intra-abdominal pressure and abdominal compartment syndrome development. The results of this study strongly confirm findings from smaller studies that the need for laparotomy during REVAR is associated with significantly worse 30-day survival. Copyright © 2016. Published by Elsevier Inc.

  15. Coping with Fear of Recurrence

    ... What Comes Next After Finishing Treatment Coping With Fear of Recurrence Having a Baby After Cancer: Pregnancy ... treatment and preparing for the future. Coping With Fear of Recurrence Learn ways to manage the fear ...

  16. Intra-abdominal hypertension in fulminant Clostridium difficile infection--an under-recognized treatable complication.

    Oud, Lavi

    2010-09-01

    Clostridium difficile is the most common cause of nosocomial infectious diarrhea in adults, with recent reports of increased severity and case fatality. Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized and treatable complications of severe illness in medical patients, and are independent predictors of mortality. Patients with severe Clostridium difficile infection (CDI) are at increased risk for IAH and ACS. However, ACS has been only rarely described in this population. We report a case of a 61 year-old morbidly obese, chronically ill, ventilator dependent patient, who developed fulminant CDI, including progressive colonic distension, acute renal failure and intra-abdominal fluid sequestration. Her clinical course worsened abruptly, with new shock, worsening hypoxic respiratory failure, increased peak airway pressures and reduced tidal volumes. Intra-abdominal pressure was 30 mm Hg. The patient was not considered a surgical candidate, was refractory to escalating non-surgical support, and died following withdrawal of life support. Although patients with fulminant CDI share many risk factors for IAH and ACS, these conditions were rarely reported in this population and are likely under recognized, as was the case with the present patient. Increased vigilance for IAH is needed in this at-risk population.

  17. Chaotic diagonal recurrent neural network

    Wang Xing-Yuan; Zhang Yi

    2012-01-01

    We propose a novel neural network based on a diagonal recurrent neural network and chaos, and its structure and learning algorithm are designed. The multilayer feedforward neural network, diagonal recurrent neural network, and chaotic diagonal recurrent neural network are used to approach the cubic symmetry map. The simulation results show that the approximation capability of the chaotic diagonal recurrent neural network is better than the other two neural networks. (interdisciplinary physics and related areas of science and technology)

  18. Acute lumbar paraspinal compartment syndrome: a systematic review.

    Alexander, William; Low, Nelson; Pratt, George

    2018-01-08

    While still a rare entity, acute lumbar paraspinal compartment syndrome has an increasing incidence. Similar to other compartment syndromes, acute lumbar paraspinal compartment syndrome is defined by raised pressure within a closed fibro-osseous space, limiting tissue perfusion within that space. The resultant tissue ischaemia presents as acute pain, and if left untreated, it may result in permanent tissue damage. A literature search of 'paraspinal compartment syndrome' revealed 21 articles. The details from a case encountered by the authors are also included. A common data set was extracted, focusing on demographics, aetiology, clinical features, management and outcomes. There are 23 reported cases of acute compartment syndrome. These are typically caused by weight-lifting exercises, but may also result from other exercises, direct trauma or non-spinal surgery. Pain, tenderness and paraspinal paraesthesia are key clinical findings. Serum creatine kinase, magnetic resonance imaging and intracompartment pressure measurement confirm the diagnosis. Half of the reported cases have been managed with surgical fasciotomy, and these patients have all had good outcomes relative to those managed with conservative measures with or without hyperbaric oxygen therapy. These good outcomes were despite significant delays to operative intervention. The diagnostic uncertainty and subsequent delay to fasciotomy result from the rarity of this disease entity, and a high level of suspicion is recommended in the appropriate setting. This is particularly true in light of the current popularity of extreme weight lifting in non-professional athletes. Operative intervention is strongly recommended in all cases based on the available evidence. © 2018 Royal Australasian College of Surgeons.

  19. Lift-and-fill face lift: integrating the fat compartments.

    Rohrich, Rod J; Ghavami, Ashkan; Constantine, Fadi C; Unger, Jacob; Mojallal, Ali

    2014-06-01

    Recent discovery of the numerous fat compartments of the face has improved our ability to more precisely restore facial volume while rejuvenating it through differential superficial musculoaponeurotic system treatment. Incorporation of selective fat compartment volume restoration along with superficial musculoaponeurotic system manipulation allows for improved control in recontouring while addressing one of the key problems in facial aging, namely, volume deflation. This theory was evaluated by assessing the contour changes from simultaneous face "lifting" and "filling" through fat compartment-guided facial fat transfer. A review of 100 face-lift patients was performed. All patients had an individualized component face lift with fat grafting to the nasolabial fold, deep malar, and high/lateral malar fat compartment locations. Photographic analysis using a computer program was conducted on oblique facial views preoperatively and postoperatively, to obtain the most projected malar contour point. Two independent observers visually evaluated the malar prominence and nasolabial fold improvements based on standardized photographs. Nasolabial fold improved by at least one grade in 81 percent and by over one grade in 11 percent. Malar prominence average projection increase was 13.47 percent and the average amount of lift was 12.24 percent. The malar prominence score improved by at least one grade in 62 percent of the patients postoperatively, and 9 percent had a greater than one grade improvement. Twenty-eight percent of the patients had a convex malar prominence postoperatively compared with 6 percent preoperatively. Malar prominence improved by at least one grade in 63 percent and by over one grade in 10 percent. The lift-and-fill face lift merges two key concepts in facial rejuvenation: (1) effective tissue manipulation by means of lifting and tightening in differential vectors according to original facial asymmetry and shape; and (2) selective fat compartment filling

  20. Colopancreatic Fistula: An Uncommon Complication of Recurrent Acute Pancreatitis

    Mouhanna Abu Ghanimeh

    2018-01-01

    Full Text Available Colonic complications, including colopancreatic fistulas (CPFs, are uncommon after acute and chronic pancreatitis. However, they have been reported and are serious. CPFs are less likely to close spontaneously and are associated with a higher risk of complications. Therefore, more definitive treatment is required that includes surgical and endoscopic options. We present a case of a 62-year-old male patient with a history of heavy alcohol intake and recurrent acute pancreatitis who presented with a 6-month history of watery diarrhea and abdominal pain. His abdominal imaging showed a possible connection between the colon and the pancreas. A further multidisciplinary workup by the gastroenterology and surgery teams, including endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, and colonoscopy, resulted in a diagnosis of CPF. A distal pancreatectomy and left hemicolectomy were performed, and the diagnosis of CPF was confirmed intraoperatively. The patient showed improvement afterward.

  1. Neisseria meningitidis presenting as acute abdomen and recurrent reactive pericarditis

    Karolina Akinosoglou

    2016-11-01

    Full Text Available Meningococcal meningitis is a well established potential fatal infection characterized by fever, headache, petechial rash, and vomiting in the majority of cases. However, protean manifestations including abdominal pain, sore throat, diarrhea and cough, even though rare, should not be overlooked. Similarly, although disseminated infection could potentially involve various organ-targets, secondary immune related complications including joints or pericardium should be dealt with caution, since they remain unresponsive to appropriate antibiotic regimens. We hereby report the rare case of an otherwise healthy adult female, presenting with acute abdominal pain masking Neisseria meningitidis serotype B meningitis, later complicated with recurrent reactive pericarditis despite appropriate antibiotic treatment. There follows a review of current literature.

  2. Immunomodulators to treat recurrent miscarriage

    Prins, Jelmer R.; Kieffer, Tom E.C.; Scherjon, Sicco A.

    2014-01-01

    Recurrent miscarriage is a reproductive disorder affecting many couples. Although several factors are associated with recurrent miscarriage, in more than 50% of the cases the cause is unknown. Maladaptation of the maternal immune system is associated with recurrent miscarriage and could explain part

  3. Associations of diet and breed with recurrence of calcium oxalate cystic calculi in dogs.

    Allen, Heidi S; Swecker, William S; Becvarova, Iveta; Weeth, Lisa P; Werre, Stephen R

    2015-05-15

    To evaluate the long-term risk of recurrence of calcium oxalate (CaOx) cystic calculi in dogs of various breeds fed 1 of 2 therapeutic diets. Retrospective cohort study. Animals-135 dogs with a history of CaOx cystic calculi. Medical records for 4 referral hospitals were searched to identify dogs that had had CaOx cystic calculi removed. Owners were contacted and medical records evaluated to obtain information on postoperative diet, recurrence of signs of lower urinary tract disease, and recurrence of cystic calculi. Dogs were grouped on the basis of breed (high-risk breeds, low-risk breeds, and Miniature Schnauzers) and diet fed after removal of cystic calculi (diet A, diet B, and any other diet [diet C], with diets A and B being therapeutic diets formulated to prevent recurrence of CaOx calculi). Breed group was a significant predictor of calculi recurrence (as determined by abdominal radiography or ultrasonography), with Miniature Schnauzers having 3 times the risk of recurrence as did dogs of other breeds. Dogs in diet group A had a lower prevalence of recurrence than did dogs in diet group C, but this difference was not significant in multivariable analysis. Results indicated that Miniature Schnauzers had a higher risk of CaOx cystic calculi recurrence than did dogs of other breeds. In addition, findings suggested that diet may play a role in decreasing recurrence, but future prospective studies are needed to validate these observations.

  4. Recurrent giant juvenile fibroadenoma

    Kathryn S. King

    2017-11-01

    Full Text Available Breast masses in children, though rare, present a difficult clinical challenge as they can represent a wide variety of entities from benign fibroadenomas to phyllodes tumors. Rapidly growing or recurrent masses can be particularly concerning to patients, families and physicians alike. Clinical examination and conventional imaging modalities are not efficacious in distinguishing between different tumor types and surgical excision is often recommended for both final diagnosis and for treatment of large or rapidly growing masses. While surgical excision can result in significant long-term deformity of the breast there are some surgical techniques that can be used to limit deformity and/or aid in future reconstruction. Here we present a case of recurrent giant juvenile fibroadenoma with a review of the clinical presentation, diagnostic tools and treatment options.

  5. Recurrent Partial Words

    Francine Blanchet-Sadri

    2011-08-01

    Full Text Available Partial words are sequences over a finite alphabet that may contain wildcard symbols, called holes, which match or are compatible with all letters; partial words without holes are said to be full words (or simply words. Given an infinite partial word w, the number of distinct full words over the alphabet that are compatible with factors of w of length n, called subwords of w, refers to a measure of complexity of infinite partial words so-called subword complexity. This measure is of particular interest because we can construct partial words with subword complexities not achievable by full words. In this paper, we consider the notion of recurrence over infinite partial words, that is, we study whether all of the finite subwords of a given infinite partial word appear infinitely often, and we establish connections between subword complexity and recurrence in this more general framework.

  6. Streptococcus pyogenes pharyngeal colonization resulting in recurrent, prepubertal vulvovaginitis.

    Hansen, Megan T; Sanchez, Veronica T; Eyster, Kathleen; Hansen, Keith A

    2007-10-01

    Recurrent, prepubertal, vaginal infections are an uncommon, troublesome problem for the patient and her family. Failure of initial therapy to alleviate vulvovaginitis may be related to vulvar skin disease, foreign body, sexual abuse, pinworms, reactions to medications, anatomic anomalies, or allergies. This report describes a case of recurrent Streptococcus pyogenes vulvovaginitis secondary to presumed vaginal re-inoculation from pharyngeal colonization. A 4-yr-old presented with one year of culture proven, recurrent Streptococcus pyogenes vulvovaginitis. Her symptoms repeatedly resolved with penicillin therapy, but continued to recur following cessation of antibiotic therapy. Evaluation included physical examination, trans-abdominal pelvic ultrasound, and vaginoscopy which all revealed normal upper and lower genital tract anatomy. Both the patient and her mother demonstrated culture proven, Group A Streptococcus pharyngeal colonization. Because of the possibility of repeated inoculations of the vaginal area from the colonized pharynx, they were both treated for decolonization with a regimen of amoxicillin and rifampin for ten days. Following this therapy there was resolution of vaginal symptoms with no further recurrence. Follow-up pharyngeal culture done on both mother and child on their last visit were negative for Group A Streptococcus. This case demonstrated an unusual specific cause of recurrent vaginitis resulting from presumed self or maternal re-inoculation with group A beta-hemolytic streptococcus from pharyngeal colonization. Group A beta-hemolytic streptococcus are consistently sensitive to penicillin, but up to 25% of acute pharyngitis cases treated with penicillin having continued asymptomatic, bacterial carriage within the nasopharynx. Thus initial alleviation of symptoms in a patient with Group A beta-hemolytic vulvovaginitis treated with penicillin, can have continued asymptomatic pharyngeal colonization which can result in recurrence of the

  7. Does evaluation of the ligamentous compartment enhance diagnostic utility of sacroiliac joint MRI in axial spondyloarthritis?

    Weber, Ulrich; Maksymowych, Walter P; Chan, Stanley M

    2015-01-01

    in the ligamentous compartment and their potential diagnostic utility in axial SpA. We therefore aimed to evaluate the ligamentous compartment on sacroiliac joint MRI for lesion distribution and potential incremental value towards diagnosis of SpA over and above the traditional assessment of the cartilaginous...... and ligamentous compartment. The incremental value of evaluating the ligamentous additionally to the cartilaginous compartment alone for diagnosis of SpA was graded qualitatively. We determined the lesion distribution between the two compartments, and the impact of the ligamentous compartment evaluation...... on diagnostic utility. RESULTS: MRI bone marrow lesions solely in the ligamentous compartment in the absence of lesions in the cartilaginous compartment were reported in just 0-2.0/0-4.0 % (BME/fat metaplasia) of all subjects. Additional assessment of the ligamentous compartment was regarded as essential...

  8. Mesh versus non-mesh repair of ventral abdominal hernias

    Jawaid, M.A.; Talpur, A.H.

    2008-01-01

    To investigate the relative effectiveness of mesh and suture repair of ventral abdominal hernias in terms of clinical outcome, quality of life and rate of recurrence in both the techniques. This is a retrospective descriptive analysis of 236 patients with mesh and non-mesh repair of primary ventral hernias performed between January 2000 to December 2004 at Surgery Department, Liaquat University of Medical and Health Sciences, Jamshoro. The record sheets of the patients were analyzed and data retrieved to compare the results of both techniques for short-term and long-term results. The data retrieved is statistically analyzed on SPSS version 11. There were 43 (18.22%) males and 193 (81.77%) females with a mean age of 51.79 years and a range of 59 (81-22). Para-umbilical hernia was the commonest of ventral hernia and accounted for 49.8% (n=118) of the total study population followed by incisional hernia comprising 24% (n=57) of the total number. There was a significant difference in the recurrent rate at 3 years interval with 23/101 (22.77%) recurrences in suture-repaired subjects compared to 10/135 (7.40%) in mesh repair group. Chronic pain lasting up to 1-2 years was noted in 14 patients with suture repair. Wound infection is comparatively more common (8.14%) in mesh group. The other variables such as operative and postoperative complications, total hospital stay and quality of life is also discussed. Mesh repair of ventral hernia is much superior to non-mesh suture repair in terms of recurrence and overall outcome. (author)

  9. Evaluation of the levels of metalloproteinsase-2 in patients with abdominal aneurysm and abdominal hernias.

    Antoszewska, Magdalena

    2013-05-01

    Abdominal aortic aneurysms and abdominal hernias become an important health problems of our times. Abdominal aortic aneurysm and its rupture is one of the most dangerous fact in vascular surgery. There are some theories pointing to a multifactoral genesis of these kinds of diseases, all of them assume the attenuation of abdominal fascia and abdominal aortic wall. The density and continuity of these structures depend on collagen and elastic fibers structure. Reducing the strength of the fibers may be due to changes in the extracellular matrix (ECM) by the proteolytic enzymes-matrix metalloproteinases (MMPs) that degrade extracellular matrix proteins. These enzymes play an important role in the development of many disease: malignant tumors (colon, breast, lung, pancreas), cardiovascular disease (myocardial infarction, ischemia-reperfusion injury), connective tissue diseases (Ehler-Danlos Syndrome, Marfan's Syndrome), complications of diabetes (retinopathy, nephropathy). One of the most important is matrix metalloproteinase-2 (MMP-2). The aim of the study was an estimation of the MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia, and in patients with only abdominal aortic aneurysm. The study involved 88 patients aged 42 to 89 years, including 75 men and 13 women. Patients were divided into two groups: patients with abdominal aortic aneurysm and primary abdominal hernia (45 persons, representing 51.1% of all group) and patients with only abdominal aortic aneurysm (43 persons, representing 48,9% of all group). It was a statistically significant increase in MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia compared to patients with only abdominal aortic aneurysm. It was a statistically significant increase in the prevalence of POCHP in patients with only abdominal aortic aneurysm compared to patients with abdominal aortic aneurysm and primary abdominal hernia. Statistically significant

  10. Recurrent epileptic Wernicke aphasia.

    Sahaya, Kinshuk; Dhand, Upinder K; Goyal, Munish K; Soni, Chetan R; Sahota, Pradeep K

    2010-04-15

    We report a patient with recurrent epileptic Wernicke aphasia who prior to this presentation, had been misdiagnosed as transient ischemic attacks for several years. This case report emphasizes the consideration of epileptic nature of aphasia when a clear alternate etiology is unavailable, even when EEG fails to show a clear ictal pattern. We also present a brief discussion of previously reported ictal aphasias. Copyright 2010 Elsevier B.V. All rights reserved.

  11. Training Recurrent Networks

    Pedersen, Morten With

    1997-01-01

    Training recurrent networks is generally believed to be a difficult task. Excessive training times and lack of convergence to an acceptable solution are frequently reported. In this paper we seek to explain the reason for this from a numerical point of view and show how to avoid problems when...... training. In particular we investigate ill-conditioning, the need for and effect of regularization and illustrate the superiority of second-order methods for training...

  12. Abdominal manifestations of autoimmune disorders

    Triantopoulou, C.

    2015-01-01

    Full text: Immunoglobulin G4-related disease was recognized as a systemic disease since various extrapancreatic lesions were observed in patients with autoimmune pancreatitis (AIP). The real etiology and pathogenesis of IgG4-RD is still not clearly understood. Moreover the exact role of IgG4 or IgG4-positive plasma cells in this disease has not yet been elucidated. only some inconsistent biological features such as hypergammaglobulinemia or hypocomplementemia support the autoimmune nature of the disease process. various names have been ascribed to this clinicopathological entity including IgG4-related sclerosing disease, IgG4-related systemic sclerosing disease, IgG4-related disease, IgG4-related autoimmune disease, hyper-IgG4 disease and IgG4-related systemic disease. The extrapancreatic lesions of IgG4-RD also exhibit the same characteristic histologic features including dense lymphoplasmacytic infiltrate, massive storiform fibrosis, and obliterative phlebitis as seen in IgG4-related pancreatitis. Abdominal manifestations include the following organs/systems: Bile ducts: Sclerosing cholangitis; Gallbladder and liver: Acalculous sclerosis cholecytitis with diffuse wall thickening; hepatic inflammatory pseudotumorts; Kidneys: round or wedge-shaped renal cortical nodules, peripheral cortical; lesions, mass like lesions or renal pelvic involvement; Prostate, urethra, seminal vesicle, vas deferens, uterine cervix; Autoimmune prostatitis; Retroperitoneum: Retroperitoneal fibrosis. thin or mildly thick homogeneous soft tissue lesion surrounding the abdominal aorta and its branches but also bulky masses causing hydronephroureterosis; Mesentery: Sclerosing mesenteritis usually involving the root of the mesentery; Bowel: Inflammatory bowel diseases mimicking Crohn’s disease or ulcerative colitis. various types of sclerosing nodular lesions of the bowel wall; Stomach: Gastritis, gastric ulcers and focal masses mimicking submucosal tumor; omentum: Infiltration mimicking

  13. Recurrent Tricuspid Insufficiency

    Kara, Ibrahim; Koksal, Cengiz; Cakalagaoglu, Canturk; Sahin, Muslum; Yanartas, Mehmet; Ay, Yasin; Demir, Serdar

    2013-01-01

    This study compares the medium-term results of De Vega, modified De Vega, and ring annuloplasty techniques for the correction of tricuspid insufficiency and investigates the risk factors for recurrent grades 3 and 4 tricuspid insufficiency after repair. In our clinic, 93 patients with functional tricuspid insufficiency underwent surgical tricuspid repair from May 2007 through October 2010. The study was retrospective, and all the data pertaining to the patients were retrieved from hospital records. Functional capacity, recurrent tricuspid insufficiency, and risk factors aggravating the insufficiency were analyzed for each patient. In the medium term (25.4 ± 10.3 mo), the rates of grades 3 and 4 tricuspid insufficiency in the De Vega, modified De Vega, and ring annuloplasty groups were 31%, 23.1%, and 6.1%, respectively. Logistic regression analysis revealed that chronic obstructive pulmonary disease, left ventricular dysfunction (ejection fraction, tricuspid insufficiency. Medium-term survival was 90.6% for the De Vega group, 96.3% for the modified De Vega group, and 97.1% for the ring annuloplasty group. Ring annuloplasty provided the best relief from recurrent tricuspid insufficiency when compared with DeVega annuloplasty. Modified De Vega annuloplasty might be a suitable alternative to ring annuloplasty when rings are not available. PMID:23466680

  14. Multiplex Recurrence Networks

    Eroglu, Deniz; Marwan, Norbert

    2017-04-01

    The complex nature of a variety of phenomena in physical, biological, or earth sciences is driven by a large number of degrees of freedom which are strongly interconnected. Although the evolution of such systems is described by multivariate time series (MTS), so far research mostly focuses on analyzing these components one by one. Recurrence based analyses are powerful methods to understand the underlying dynamics of a dynamical system and have been used for many successful applications including examples from earth science, economics, or chemical reactions. The backbone of these techniques is creating the phase space of the system. However, increasing the dimension of a system requires increasing the length of the time series in order get significant and reliable results. This requirement is one of the challenges in many disciplines, in particular in palaeoclimate, thus, it is not easy to create a phase space from measured MTS due to the limited number of available obervations (samples). To overcome this problem, we suggest to create recurrence networks from each component of the system and combine them into a multiplex network structure, the multiplex recurrence network (MRN). We test the MRN by using prototypical mathematical models and demonstrate its use by studying high-dimensional palaeoclimate dynamics derived from pollen data from the Bear Lake (Utah, US). By using the MRN, we can distinguish typical climate transition events, e.g., such between Marine Isotope Stages.

  15. Mechanisms and management of functional abdominal pain

    Farmer, Adam D; Aziz, Qasim

    2014-01-01

    Functional abdominal pain syndrome is characterised by frequent or continuous abdominal pain associated with a degree of loss of daily activity. It has a reported population prevalence of between 0.5% and 1.7%, with a female preponderance. The pathophysiology of functional abdominal pain is incompletely understood although it has been postulated that peripheral sensitisation of visceral afferents, central sensitisation of the spinal dorsal horn and aberrancies within descending modulatory sys...

  16. [Diagnostic imaging and acute abdominal pain].

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  17. Actinomycosis mimicking abdominal neoplasm. Case report

    Waaddegaard, P; Dziegiel, Morten Hanefeld

    1988-01-01

    In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil......In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed...... by penicillin treatment gave a good result....

  18. Diffuse Abdominal Splenosis Mimicking Peritoneal Metastases in a 35-Year-Old Man with a Resectable Carcinoma of the Ampulla of Vater

    Steffen Filskov Sorensen

    2013-09-01

    Full Text Available A 35-year-old man with a history of blunt abdominal trauma and splenic rupture was diagnosed with an ampullary adenocarcinoma. At workup, a CT scan showed multiple intra-abdominal lesions similar to peritoneal carcinosis, and the patient was referred for palliative chemotherapy. On clinical suspicion, however, a biopsy was performed on an intra-abdominal lesion, establishing the diagnosis of abdominal splenosis. A radical pancreaticoduodenectomy ad modum Whipple was performed, followed by adjuvant chemotherapy with gemcitabine. At the 18-month follow-up, the patient was free from recurrent disease. We conclude that splenosis should be considered as a differential diagnosis of peritoneal metastases in cancer patients with a history of abdominal trauma and/or splenectomy. Other reports on splenosis in cancer patients and diagnostic workup are discussed.

  19. Intestinal lymphangiectasia associated with recurrence of histiocytosis X.

    Hui, C K

    2011-09-01

    Intestinal lymphangiectasia may occur as a primary congenital disorder or a secondary disorder. Secondary lymphangiectasia could be associated with diseases such as abdominal carcinoma, retroperitoneal fibrosis or chronic pancreatitis. This is the first reported case of intestinal lymphangiectasia associated with recurrent histiocytosis X. This case report illustrates the need for more prospective, well-designed studies to determine the natural history and outcome of intestinal lymphangiectasia in the duodenum. Hopefully, these studies will also help clinicians identify which group of patients with intestinal lymphangiectasia in the duodenum is more likely to have a secondary cause.

  20. Recurrence of Solid Pseudopapillary Tumor: A Rare Pancreatic Tumor

    Chandra Punch

    2016-01-01

    Full Text Available Solid pseudopapillary tumor of the pancreas (SPTP is a rare disease of young females that does not usually recur after resection. Here we report a case of an elderly female with history of SPTP ten years ago who presented with anorexia and a palpable left lower quadrant abdominal mass. Imaging revealed metastatic disease and US-guided biopsy of the liver confirmed the diagnosis of SPTP. Due to her advanced age and comorbidities, she elected to undergo hospice care. The objective of this case report is to increase awareness of this tumor and its possibility of recurrence, necessitating further guidelines for follow-up.

  1. Predictors of recurrence in pheochromocytoma.

    Press, Danielle; Akyuz, Muhammet; Dural, Cem; Aliyev, Shamil; Monteiro, Rosebel; Mino, Jeff; Mitchell, Jamie; Hamrahian, Amir; Siperstein, Allan; Berber, Eren

    2014-12-01

    The recurrence rate of pheochromocytoma after adrenalectomy is 6.5-16.5%. This study aims to identify predictors of recurrence and optimal biochemical testing and imaging for detecting the recurrence of pheochromocytoma. In this retrospective study we reviewed all patients who underwent adrenalectomy for pheochromocytoma during a 14-year period at a single institution. One hundred thirty-five patients had adrenalectomy for pheochromocytoma. Eight patients (6%) developed recurrent disease. The median time from initial operation to diagnosis of recurrence was 35 months. On multivariate analysis, tumor size >5 cm was an independent predictor of recurrence. One patient with recurrence died, 4 had stable disease, 2 had progression of disease, and 1 was cured. Recurrence was diagnosed by increases in plasma and/or urinary metanephrines and positive imaging in 6 patients (75%), and by positive imaging and normal biochemical levels in 2 patients (25%). Patients with large tumors (>5 cm) should be followed vigilantly for recurrence. Because 25% of patients with recurrence had normal biochemical levels, we recommend routine imaging and testing of plasma or urinary metanephrines for prompt diagnosis of recurrence. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Mechanical ventilation in abdominal surgery.

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEPventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  3. Abdominal ultrasound in AIDS patients

    Escribano, J.; Gonzalez, J.; Alvarez, M.; Rivero, S.; Raya, J.L.; Ruza, M.

    1998-01-01

    To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,

  4. Don't Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries after Nonpenetrating Trauma.

    Matalon, Shanna A; Askari, Reza; Gates, Jonathan D; Patel, Ketan; Sodickson, Aaron D; Khurana, Bharti

    2017-01-01

    Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury). These injuries are often overlooked clinically because of (a) a lack of findings at physical examination or (b) distraction by more-severe associated injuries. However, these injuries are important to detect because they are highly associated with potentially grave visceral and vascular injuries, such as aortic injury, and because their detection can lead to the diagnosis of these more clinically important grave traumatic injuries. Failure to make a timely diagnosis can result in delayed complications, such as bowel hernia with potential for obstruction or strangulation, or misdiagnosis of an abdominal wall neoplasm. Groin injuries, such as athletic pubalgia, and inferior costochondral injuries should also be considered in patients with abdominal pain after nonpenetrating trauma, because these conditions may manifest with referred abdominal pain and are often included within the field of view at cross-sectional abdominal imaging. Radiologists must recognize and report acute abdominal wall injuries and their associated intra-abdominal pathologic conditions to allow appropriate and timely treatment. © RSNA, 2017.

  5. Chronic appendicitis in a patient with 15 years abdominal pain

    bizhan Khorasani

    2007-04-01

    Full Text Available Khorasani B1, Gholizadeh Pasha A2 1. Assistant professor, Department of surgery, Faculty of medicine, Tehran University of rehabilitation 2. Assistant professor, Department of surgery, Faculty of medicine, Babol University of medical sciences Abstract Background: Acute appendicitis is a completely known disease but for many physicians chronic appendicitis is unknown and some of them don believe in it. Although the number of people suffer from chronic appendicitis is much fewer than those who suffer from acute appendicitis, we shouldn ignore it. Clinical symptoms for these patients are chronic, longtime and recurrent abdominal pain, which is usually in the right lower quadrant of the abdomen. In the Para clinical examinations there isn any considerable pathological problem (in urine, stool, and sonography of the abdomen and pelvis. By recognizing appendicitis and appendectomy, the symptoms will be vanished and the patients will recover. Case presentation: The case was a 57-year-old man who has complained from chronic abdominal pain in the RLQ area since 15years ago. No pathological problem had been found in all diagnostic process. Conclusion: The problem was diagnosed as the chronic appendicitis and he underwent the appendectomy by laparoscopic procedure and was completely recovered.

  6. Re-irradiation for abdominal tumor. Preliminary results

    Narisada, Hiroyuki; Imada, Hajime; Tomoda, Yoshinori

    2012-01-01

    The purpose of this study was to assess the efficacy of loco-regional radiotherapy for recurrent abdominal tumor treated with re-irradiation. Re-irradiated areas of 16 patients were eight of pelvic space, five of retroperitonium and three of liver or porta hepatica. Eligibility criteria of re-irradiation were success of initial irradiation, no other effective treatment except re-irradiation, constancy of bowel gas at hunger status and respiratory movement, visceral dosage reduction at re-irradiation. Total dose of initial, second course of radiation were 51.3±10.8 Gy, 50.6±14.2 Gy, respectively. Interval of initial and second course of radiation were 16.6±10.2 months. Local control after second course of radiation was four cases of complete response, five of partial response and seven of stable disease. Median survival periods were 55 months after initial treatment and 28 months after second course of radiation. In two cases of pelvic reirradiation, skin to pelvic space fistula was occurred. Re-irradiation for abdominal tumor may become useful salvage treatment. (author)

  7. [Cultural and migration aspects in functional abdominal pain].

    Buri, Caroline; Laederach, Kurt

    2011-08-01

    Compared to Europe's mean immigrant contingent of 7.3 to 8.6 % Switzerland holds the highest contingent of foreign population with 23.5 %. Therefore it is of utmost importance that physicians have a knowledge of the specific characteristics of immigrant patients. The influence of personality factors (experience, behavior) is not independent from the influence of culturally-related environmental factors (regional differences in diet, pollutants, meanings, etc.). In addition, different cultural groups rate their quality of life differently. Psychological reasons for recurrent abdominal pain are stress (life events), effects of self-medication (laxatives, cocaine) and sexual abuse but also rare infectious diseases are more common among immigrants (e.g. tuberculosis, histoplasmosis, etc.). Migration-specific characteristics are mainly to find in the semiotics of the symptoms: not every abdominal pain is real pain in the abdomen. Finally, it is crucial to make the distinction between organic, functional and psychological-related pain. This can, however, usually only be accomplished in the context of the entire situation of a patient and, depending on the situation, with the support of a colleague from the appropriate cultural group or an experienced interpreter. In this review we limit ourselves to the presentation of the working population of the migrants, because these represent the largest group of all migrants. The specific situation of asylum seekers will also be refrained to where appropriate.

  8. Air quality inside the passenger compartment of a bus.

    Conceição, E Z; Silva, M C; Viegas, D X

    1997-01-01

    The indoor air quality in the passenger compartment of an intercity bus is studied. A system used for the remotion of the contaminants from the compartment, based on an extraction duct, was projected using a simple, unidimensional flow model with capability to predict the air exchange rate as a function of the vehicle velocity. Some tests using tracer gan methods were performed in a real vehicle with the contaminant remotion system mounted, in order to validate the calculation model and evaluate the performances of the system. A good agreement between the predicted and the experimental results was verified and the obtained air exchange rate was quite reasonable when compared with the former situation, without extraction duct.

  9. CoMIC, the hidden dynamics of mitochondrial inner compartments.

    Cho, Bongki; Sun, Woong

    2017-12-01

    Mitochondria have evolutionarily, functionally and structurally distinct outer- (OMM) and inner-membranes (IMM). Thus, mitochondrial morphology is controlled by independent but coordinated activity of fission and fusion of the OMM and IMM. Constriction and division of the OMM are mediated by endocytosis-like machineries, which include dynamin-related protein 1 with additional cytosolic vesicle scissoring machineries such as actin filament and Dynamin 2. However, structural alteration of the IMM during mitochondrial division has been poorly understood. Recently, we found that the IMM and the inner compartments undergo transient and reversible constriction prior to the OMM division, which we termed CoMIC, Constriction of Mitochondrial Inner Compartment. In this short review, we further discuss the evolutionary perspective and the regulatory mechanism of CoMIC during mitochondrial division. [BMB Reports 2017; 50(12): 597-598].

  10. Postoperative findings following the Whipple procedure: determination of prevalence and morphologic abdominal CT features

    Mortele, K.J.; Lemmerling, M.; Bock, G. de; Kunnen, M. [Department of Radiology, University Hospital Gent (Belgium); Hemptinne, B. de [Department of Digestive Surgery, University Hospital Gent (Belgium); Vos, M. de [Department of Gastroenterology, University Hospital Gent (Belgium)

    2000-01-01

    This study was conducted to determine characteristic CT findings following the Whipple procedure and to evaluate the usefulness of CT in predicting tumor recurrence. Eighty-four postoperative abdominal CT scans and medical records of 43 patients were retrospectively reviewed. Perioperative histopathologic examinations revealed malignancy in 32 patients (74.4 %). Time interval between surgery and CT varied from 13 days to 6 years and 7 months. Common postoperative findings were unopacified anastomotic bowel loops in the porta hepatis (n = 69 scans), perivascular cuffing (n = 42 scans), pneumobilia (n = 40 scans), dilated intrahepatic bile ducts (n = 22 scans), reactive lymphadenopathy (n = 21 scans), and transient fluid collections (n = 20 scans). Postoperative complications were detected on 17 CT scans (20.2 %): generalized ascites (n = 8 patients), deep abscesses (n = 3 patients), wound abscess (n = 1 patient), pancreatitis (n = 1 patient), and pseudomembranous colitis (n = 1 patient). Tumor recurrence appeared in 15 patients (46.8 %) after a mean postoperative period of 11 months (1 month to 3 years): local (9 of 15), regional lymph nodes (9 of 15), and liver metastasis (8 of 15). Detection of generalized ascites more than 30 days after surgery was associated with tumor recurrence in 6 of 6 patients (100 %). Diffuse ascites (> 30 days after surgery) behaved as an early predictive sign of tumor recurrence. In our series CT accuracy for detecting recurrent tumor with CT was 93.5 %. No predilection site for disease recurrence could be determined. (orig.)

  11. The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 1: definitions and pathophysiology.

    Malbrain, Manu L N G; Roberts, Derek J; De Laet, Inneke; De Waele, Jan J; Sugrue, Michael; Schachtrupp, Alexander; Duchesne, Juan; Van Ramshorst, Gabrielle; De Keulenaer, Bart; Kirkpatrick, Andrew W; Ahmadi-Noorbakhsh, Siavash; Mulier, Jan; Ivatury, Rao; Pracca, Francisco; Wise, Robert; Pelosi, Paolo

    2014-01-01

    Over the last few decades, increasing attention has been paid to understanding the pathophysiology, aetiology, prognosis, and treatment of elevated intra-abdominal pressure (IAP) in trauma, surgical, and medical patients. However, there is presently a relatively poor understanding of intra-abdominal volume (IAV) and the relationship between IAV and IAP (i.e. abdominal compliance). Consensus definitions on Cab were discussed during the 5th World Congress on Abdominal Compartment Syndrome and a writing committee was formed to develop this article. During the writing process, a systematic and structured Medline and PubMed search was conducted to identify relevant studies relating to the topic. According to the recently updated consensus definitions of the World Society on Abdominal Compartment Syndrome (WSACS), abdominal compliance (Cab) is defined as a measure of the ease of abdominal expansion, which is determined by the elasticity of the abdominal wall and diaphragm. It should be expressed as the change in IAV per change in IAP (mL [mm Hg]⁻¹). Importantly, Cab is measured differently than IAP and the abdominal wall (and its compliance) is only a part of the total abdominal pressure-volume (PV) relationship. During an increase in IAV, different phases are encountered: the reshaping, stretching, and pressurisation phases. The first part of this review article starts with a comprehensive list of the different definitions related to IAP (at baseline, during respiratory variations, at maximal IAV), IAV (at baseline, additional volume, abdominal workspace, maximal and unadapted volume), and abdominal compliance and elastance (i.e. the relationship between IAV and IAP). An historical background on the pathophysiology related to IAP, IAV and Cab follows this. Measurement of Cab is difficult at the bedside and can only be done in a case of change (removal or addition) in IAV. The Cab is one of the most neglected parameters in critically ill patients, although it plays a

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

    Juvenal da Rocha Torres Neto

    2007-09-01

    Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic

  13. Bacterial assemblages differ between compartments within the coral holobiont

    Sweet, M. J.; Croquer, A.; Bythell, J. C.

    2011-03-01

    It is widely accepted that corals are associated with a diverse and host species-specific microbiota, but how they are organized within their hosts remains poorly understood. Previous sampling techniques (blasted coral tissues, coral swabs and milked mucus) may preferentially sample from different compartments such as mucus, tissue and skeleton, or amalgamate them, making comparisons and generalizations between studies difficult. This study characterized bacterial communities of corals with minimal mechanical disruption and contamination from water, air and sediments from three compartments: surface mucus layer (SML), coral tissue and coral skeleton. A novel apparatus (the `snot sucker') was used to separate the SML from tissues and skeleton, and these three compartments were compared to swab samples and milked mucus along with adjacent environmental samples (water column and sediments). Bacterial 16S rRNA gene diversity was significantly different between the various coral compartments and environmental samples (PERMANOVA, F = 6.9, df = 8, P = 0.001), the only exceptions being the complete crushed coral samples and the coral skeleton, which were similar, because the skeleton represents a proportionally large volume and supports a relatively rich microflora. Milked mucus differed significantly from the SML collected with the `snot sucker' and was contaminated with zooxanthellae, suggesting that it may originate at least partially from the gastrovascular cavity rather than the tissue surface. A common method of sampling the SML, surface swabs, produced a bacterial community profile distinct from the SML sampled using our novel apparatus and also showed contamination from coral tissues. Our results indicate that microbial communities are spatially structured within the coral holobiont, and methods used to describe these need to be standardized to allow comparisons between studies.

  14. Hydrogen peroxide probes directed to different cellular compartments.

    Mikalai Malinouski; You Zhou; Vsevolod V Belousov; Dolph L Hatfield; Vadim N Gladyshev

    2011-01-01

    Background Controlled generation and removal of hydrogen peroxide play important roles in cellular redox homeostasis and signaling. We used a hydrogen peroxide biosensor HyPer, targeted to different compartments, to examine these processes in mammalian cells. Principal Findings Reversible responses were observed to various redox perturbations and signaling events. HyPer expressed in HEK 293 cells was found to sense low micromolar levels of hydrogen peroxide. When targeted to various cellular ...

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

    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.

  16. Elimination behavior of shelter dogs housed in double compartment kennels.

    Denae Wagner

    Full Text Available For animals in confinement housing the housing structure has tremendous potential to impact well being. Dogs in animal shelters are often housed in one of two types of confinement housing - single kennels and rooms or double compartment kennels and rooms most often separated by a guillotine door. This study examines the effect of housing on the location of elimination behavior in dogs housed in double compartment kennels were the majority of the dogs were walked daily. One side of the kennel contained the food, water and bed and the other side was empty and available except during cleaning time. Location of urination and defecation was observed daily for 579 dogs housed in indoor double compartment kennels for a total of 4440 days of observation. There were 1856 days (41.9% when no elimination was noted in the kennel. Feces, urine or both were observed in the kennel on 2584 days (58.1%. When elimination occurred in the kennel the probability of fecal elimination on the opposite side of the bed/food/water was 72.5% (95% CI 69.05% to 75.69%. The probability of urination on the opposite side of the bed/food/water was 77.4% (95% CI 74.33% to 80.07%. This study demonstrates the strong preference of dogs to eliminate away from the area where they eat, drink and sleep. Double compartment housing not only allows this - it allows staff the ability to provide safe, efficient, humane daily care and confers the added benefits of reducing risks for disease transmission for the individual dog as well as the population.

  17. SACHET, Dynamic Fission Products Inventory in PWR Multiple Compartment System

    Kodaira, Hideki

    1990-01-01

    1 - Description of program or function: SACHET evaluates the dynamic fission product inventories in the multiple compartment system of pressurized water reactor (PWR) plants. 2 - Method of solution: SACHET utilizes a matrix of fission product core inventory which is previously calculated by the ORIGEN code. 3 - Restrictions on the complexity of the problem: Liquid wastes such as chemical waste and detergent waste are not included

  18. The pseudo-compartment method for coupling partial differential equation and compartment-based models of diffusion.

    Yates, Christian A; Flegg, Mark B

    2015-05-06

    Spatial reaction-diffusion models have been employed to describe many emergent phenomena in biological systems. The modelling technique most commonly adopted in the literature implements systems of partial differential equations (PDEs), which assumes there are sufficient densities of particles that a continuum approximation is valid. However, owing to recent advances in computational power, the simulation and therefore postulation, of computationally intensive individual-based models has become a popular way to investigate the effects of noise in reaction-diffusion systems in which regions of low copy numbers exist. The specific stochastic models with which we shall be concerned in this manuscript are referred to as 'compartment-based' or 'on-lattice'. These models are characterized by a discretization of the computational domain into a grid/lattice of 'compartments'. Within each compartment, particles are assumed to be well mixed and are permitted to react with other particles within their compartment or to transfer between neighbouring compartments. Stochastic models provide accuracy, but at the cost of significant computational resources. For models that have regions of both low and high concentrations, it is often desirable, for reasons of efficiency, to employ coupled multi-scale modelling paradigms. In this work, we develop two hybrid algorithms in which a PDE in one region of the domain is coupled to a compartment-based model in the other. Rather than attempting to balance average fluxes, our algorithms answer a more fundamental question: 'how are individual particles transported between the vastly different model descriptions?' First, we present an algorithm derived by carefully redefining the continuous PDE concentration as a probability distribution. While this first algorithm shows very strong convergence to analytical solutions of test problems, it can be cumbersome to simulate. Our second algorithm is a simplified and more efficient implementation of

  19. Hypothyroid-induced acute compartment syndrome in all extremities.

    Musielak, Matthew C; Chae, Jung Hee

    2016-12-20

    Acute compartment syndrome (ACS) is an uncommon complication of uncontrolled hypothyroidism. If unrecognized, this can lead to ischemia, necrosis and potential limb loss. A 49-year-old female presented with the sudden onset of bilateral lower and upper extremity swelling and pain. The lower extremity anterior compartments were painful and tense. The extensor surface of the upper extremities exhibited swelling and pain. Motor function was intact, however, limited due to pain. Bilateral lower extremity fasciotomies were performed. Postoperative Day 1, upper extremity motor function decreased significantly and paresthesias occurred. She therefore underwent bilateral forearm fasciotomies. The pathogenesis of hypothyroidism-induced compartment syndrome is unclear. Thyroid-stimulating hormone-induced fibroblast activation results in increased glycosaminoglycan deposition. The primary glycosaminoglycan in hypothyroid myxedematous changes is hyaluronic acid, which binds water causing edema. This increases vascular permeability, extravasation of proteins and impaired lymphatic drainage. These contribute to increased intra-compartmental pressure and subsequent ACS. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

  20. The statolith compartment in Chara rhizoids contains carbohydrate and protein

    Wang-Cahill, F.; Kiss, J. Z.

    1995-01-01

    In contrast to higher plants, the alga Chara has rhizoids with single membrane-bound compartments that function as statoliths in gravity perception. Previous work has demonstrated that these statoliths contain barium sulfate crystals. In this study, we show that statoliths in Chara rhizoids react with a Coomassie Brilliant Blue cytochemical stain for proteins. While statoliths did not react with silver methenamine carbohydrate cytochemistry, the monoclonal antibody CCRC-M2, which is against a carbohydrate (sycamore-maple rhamnogalacturonan I), labeled the statolith compartment. These results demonstrate that in addition to barium sulfate, statoliths in Chara rhizoids have an organic matrix that consists of protein and carbohydrate moieties. Since the statoliths were silver methenamine negative, the carbohydrate in this compartment could be a 3-linked polysaccharide. CCRC-M2 also labeled Golgi cisternae, Golgi-associated vesicles, apical vesicles, and cell walls in the rhizoids. The specificity of CCRC-M2 immunolabeling was verified by several control experiments, including the demonstration that labeling was abolished when the antibody was preabsorbed with its antigen. Since in this and a previous study (John Z. Kiss and L. Andrew Staehelin, American Journal of Botany 80: 273-282, 1993) antibodies against higher plant carbohydrates crossreacted with cell walls of Chara in a specific manner, Characean algae may be a useful model system in biochemical and molecular studies of cell walls.

  1. Digital Microscopy Assessment of Angiogenesis in Different Breast Cancer Compartments

    Anca Haisan

    2013-01-01

    Full Text Available Background/Aim. Tumour angiogenesis defined by microvessel density (MVD is generally accepted as a prognostic factor in breast cancer. However, due to variability of measurement systems and cutoffs, it is questionable to date whether it contributes to predictive outline. Our study aims to grade vascular heterogeneity by comparing clear-cut compartments: tumour associated stroma (TAS, tumour parenchyma, and tumour invasive front. Material and Methods. Computerized vessel area measurement was performed using a tissue cytometry system (TissueFAXS on slides originated from 50 patients with breast cancer. Vessels were marked using immunohistochemistry with CD34. Regions of interest were manually defined for each tumour compartment. Results. Tumour invasive front vascular endothelia area was 2.15 times higher than that in tumour parenchyma and 4.61 times higher than that in TAS (P<0.002. Worth to mention that the lymph node negative subgroup of patients show a slight but constant increase of vessel index in all examined compartments of breast tumour. Conclusion. Whole slide digital examination and region of interest (ROI analysis are a valuable tool in scoring angiogenesis markers and disclosing their prognostic capacity. Our study reveals compartments’ variability of vessel density inside the tumour and highlights the propensity of invasive front to associate an active process of angiogenesis with potential implications in adjuvant therapy.

  2. Recurrent cerebral thrombosis

    Iwamoto, Toshihiko; Abe, Shin-e; Kubo, Hideki; Hanyu, Haruo; Takasaki, Masaru

    1992-01-01

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.)

  3. Stress and recurrent miscarriage.

    Craig, M

    2001-09-01

    Our current understanding into the role of stress in unexplained recurrent miscarriages comes from two different research strategies. The majority of research has examined the role of psychological support within this patient population. This support has been provided in a number of ways ranging from weekly interviews with a psychiatrist or gynaecologist and or visual re-assurance in the form of ultrasound scans. A comparison of psychological support with an absence of such intervention has found differences in successful pregnancy outcome varying from as great as 84 versus 26%, respectively. It has been assumed that psychological support reduces the miscarriage rate by reducing “stress”within this patient population. In addition it provides indirect support for a role of stress in the aetiology of unexplained recurrent miscarriage. Other studies have attempted to directly assess the effect of personality characteristics on miscarriage rate; these studies have yielded conflicting results.The mechanism by which stress may be causal in the aetiology of unexplained recurrent miscarriage has not been examined in humans. Animal studies, however, have found that psychological distress can alter immune parameters that may be intricately involved with implantation. These parameters include an elevation of the “abortive” cytokine TNF-a and a reduction in the “anti-abortive” cytokine TGF-P2. Cells that are involved in the release of TNF-a at the feto-maternal interface include T cells, macrophages and mast cells.Mechanisms through which stress may act on these cells are explored and an integrated model is postulated.

  4. Wide rectal duplication cyst in an adult resected by anterior approach: efficacy and recurrence.

    Ceriotti, Michela; Saccomani, Giorgia; Lacelli, Francesca; Saccomani, Giovanni E

    2017-06-01

    Alimentary tract duplications are uncommon congenital abnormalities usually diagnosed and treated in childhood. Rectal involvement is extremely rare. We report the case of a 22-year-old female who presented with chronic abdominal and perianal pain; feeling of rectal fullness. Workup revealed a rectal duplication cyst. The patient underwent a complete transabdominal excision of the cyst: an hybrid laparoscopic and laparotomic technique was adopted. The hybrid isolated anterior abdominal approach is safe and feasible even for the treatment of wide rectal duplication cysts. Real recurrence in rectal duplication cysts is uncommon when the first operation was performed with radical intent.

  5. Recurrent Bilateral Focal Myositis.

    Nagafuchi, Hiroko; Nakano, Hiromasa; Ooka, Seido; Takakuwa, Yukiko; Yamada, Hidehiro; Tadokoro, Mamoru; Shimojo, Sadatomo; Ozaki, Shoichi

    This report describes a rare case of recurrent bilateral focal myositis and its successful treatment via methotrexate. A 38-year-old man presented myalgia of the right gastrocnemius in May 2005. Magnetic resonance imaging showed very high signal intensity in the right gastrocnemius on short-tau inversion recovery images. A muscle biopsy revealed inflammatory CD4+ cell-dominant myogenic change. Focal myositis was diagnosed. The first steroid treatment was effective. Tapering of prednisolone, however, repeatedly induced myositis relapse, which progressed to multiple muscle lesions of both lower limbs. Initiation of methotrexate finally allowed successful tapering of prednisolone, with no relapse in the past 4 years.

  6. Recurrent Pregnancy Loss

    Véronique Piroux

    1997-01-01

    Full Text Available Antiphospholipid antibodies (APA are associated with thrombosis, thrombocytopenia and fetal loss but they occur in a variety of diseases. Despite many efforts, a correlation between the specificity of particular subgroups of APA and particular clinical situations remains to be established. The antigens at the origin of APA remain to be identified. We discuss here the possible links between cell apoptosis or necrosis, leading to plasma membrane alterations, and the occurrence of APA in response to sustained stimulation. The pathogenic potential of APA is also considered with respect to recurrent pregnancy loss.

  7. Equine recurrent airway obstruction

    Artur Niedźwiedź

    2014-10-01

    Full Text Available Equine Recurrent Airway Obstruction (RAO, also known as heaves or broken wind, is one of the most common disease in middle-aged horses. Inflammation of the airway is inducted by organic dust exposure. This disease is characterized by neutrophilic inflammation, bronchospasm, excessive mucus production and pathologic changes in the bronchiolar walls. Clinical signs are resolved in 3-4 weeks after environmental changes. Horses suffering from RAO are susceptible to allergens throughout their lives, therefore they should be properly managed. In therapy the most importanthing is to eliminate dustexposure, administration of corticosteroids and use bronchodilators to improve pulmonary function.

  8. 75 FR 6092 - Special Conditions: Model C-27J Airplane; Class E Cargo Compartment Lavatory

    2010-02-08

    ... envision that a lavatory would be installed inside a Class E cargo compartment. Lavatories, including the... envision that a lavatory would be installed in a Class E cargo compartment. Therefore, special conditions...

  9. Endocytosis of desmosomal plaques depends on intact actin filaments and leads to a nondegradative compartment

    Holm, Pernille K.; Hansen, Steen H.; Sandvig, Kirsten

    1993-01-01

    Cellebiologi, human epithelial cell line, growth inhibition, desmosomes, clathrin-independent endocytosis, cytoskeleton, nondegradative compartment......Cellebiologi, human epithelial cell line, growth inhibition, desmosomes, clathrin-independent endocytosis, cytoskeleton, nondegradative compartment...

  10. Post caesarean section anterior abdominal wall endometriosis ...

    Abdominal wall endometriosis is a likely sequelae of caesarean section as viable endometrial tissue are deposited in the peritoneal cavity or anterior abdominal wall. One such case to sensitize clinicians of this rare presentation of the disease is presented. The patient was a 48 year old woman who presented with a lesion ...

  11. Synovial sarcoma of the abdominal wall

    Matushita, J.P.K.; Matushita, J.S.

    1989-01-01

    A case report of synovial sarcoma arising in the abdominal wall is presented. A brief review of the clinical and radiological features of synovial sarcoma is made. Pre-operative diagnosis of an abdominal wall synovial sarcoma is virtually impossible, but should be considered when a soft tissue swelling is found to show amorphous stippled calcification X-ray. (author) [pt

  12. Actinomycosis mimicking abdominal neoplasm. Case report

    Waaddegaard, P; Dziegiel, M

    1988-01-01

    In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil...

  13. Asymptomatic Incisional Endometrioma Presenting as Abdominal ...

    Asymptomatic incisional endometrioma of the anterior abdominal wall is rare. Clinical diagnosis may be difficult. We present a 26 year old woman with incisional abdominal wall endometrioma discovered 5 years after caeserian section. It was painless and there was no change in size with menstruation. The patient's body ...

  14. Abdominal imaging findings in gastrointestinal basidiobolomycosis.

    Flicek, Kristina T; Vikram, Holenarasipur R; De Petris, Giovanni D; Johnson, C Daniel

    2015-02-01

    To describe the abdominal imaging findings of patients with gastrointestinal Basidiobolus ranarum infection. A literature search was performed to compile the abdominal imaging findings of all reported worldwide cases of gastrointestinal basidiobolomycosis (GIB). In addition, a retrospective review at our institution was performed to identify GIB cases that had imaging findings. A radiologist aware of the diagnosis reviewed the imaging findings in detail. Additional information was obtained from the medical records. A total of 73 GIB cases have been published in the medical literature. The most common abdominal imaging findings were masses in the colon, the liver, or multiple sites and bowel wall thickening. Initially, many patients were considered to have either a neoplasm or Crohn disease. We identified 7 proven cases of GIB at our institution, of which 4 had imaging studies (4 computed tomography [CT] examinations, 4 abdominal radiographs, and an upper gastrointestinal study). Imaging studies showed abnormalities in all 4 cases. Three-fourths of our study patients had an abdominal mass at CT. Two of 3 masses involved the kidneys and included urinary obstruction. All masses showed an inflammatory component with adjacent soft tissue stranding, with or without abscess formation. Radiologists should consider GIB when a patient from an arid climate presents with abdominal pain, weight loss, and an inflammatory abdominal mass on CT. Abdominal masses of the colon or liver, bowel wall thickening, and abscesses are the most common imaging findings.

  15. Functional abdominal pain disorders in children

    Rajindrajith, Shaman; Zeevenhooven, Judith; Devanarayana, Niranga Manjuri; Perera, Bonaventure Jayasiri Crispus; Benninga, Marc A.

    2018-01-01

    Chronic abdominal pain is a common problem in pediatric practice. The majority of cases fulfill the Rome IV criteria for functional abdominal pain disorders (FAPDs). At times, these disorders may lead to rather serious repercussions. Area covered: We have attempted to cover current knowledge on

  16. PATTERN AND OUTCOME OF ABDOMINAL INJURIES AT ...

    hi-tech

    2006-01-01

    Jan 1, 2006 ... a significant cause of abdominal injuries in Kenyatta National Hospital (KNH). The rate-of ... of selective management of abdominal injuries in. 1960 by ..... that pays great attention to the condition of the patient. (11). To aid in ...

  17. Retrospective comparison of abdominal ultrasonography and radiography in the investigation of feline abdominal disease

    Won, Wylen Wade; Sharma, Ajay; Wu, Wenbo

    2015-01-01

    Abdominal radiography and ultrasonography are commonly used as part of the initial diagnostic plan for cats with nonspecific signs of abdominal disease. This retrospective study compared the clinical usefulness of abdominal radiography and ultrasonography in 105 feline patients with signs of abdominal disease. The final diagnosis was determined more commonly with ultrasonography (59%) compared to radiography (25.7%). Ultrasonography was also able to provide additional clinically relevant information in 76% of cases, and changed or refined the diagnosis in 47% of cases. Based on these findings, ultrasonography may be sufficient as an initial diagnostic test for the investigation of feline abdominal disease. PMID:26483582

  18. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Ghodratollah Maddah

    2014-05-01

    Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

  19. Fetal abdominal magnetic resonance imaging

    Brugger, Peter C.; Prayer, Daniela

    2006-01-01

    This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages

  20. Fetal abdominal magnetic resonance imaging

    Brugger, Peter C. [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, 1090 Vienna (Austria)]. E-mail: peter.brugger@meduniwien.ac.at; Prayer, Daniela [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria)

    2006-02-15

    This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages.

  1. Acute appendicitis after blunt abdominal trauma

    Marjan Joudi

    2012-02-01

    Full Text Available Appendecitis is one of the most frequent surgeries. Inflammation of appendix may be due to variable causes such as fecalit, hypertrophy of Peyer’s plaques, seeds of fruits and parasites. In this study we presented an uncommon type of appendicitis which occurred after abdominal blunt trauma. In this article three children present who involved acute appendicitis after blunt abdominal trauma. These patients were 2 boys (5 and 6-year-old and one girl (8-year-old who after blunt abdominal trauma admitted to the hospital with abdominal pain and symptoms of acute abdomen and appendectomy had been done for them.Trauma can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after blunt abdominal trauma

  2. Mechanical characterization of porcine abdominal organs.

    Tamura, Atsutaka; Omori, Kiyoshi; Miki, Kazuo; Lee, Jong B; Yang, King H; King, Albert I

    2002-11-01

    Typical automotive related abdominal injuries occur due to contact with the rim of the steering wheel, seatbelt and armrest, however, the rate is less than in other body regions. When solid abdominal organs, such as the liver, kidneys and spleen are involved, the injury severity tends to be higher. Although sled and pendulum impact tests have been conducted using cadavers and animals, the mechanical properties and the tissue level injury tolerance of abdominal solid organs are not well characterized. These data are needed in the development of computer models, the improvement of current anthropometric test devices and the enhancement of our understanding of abdominal injury mechanisms. In this study, a series of experimental tests on solid abdominal organs was conducted using porcine liver, kidney and spleen specimens. Additionally, the injury tolerance of the solid organs was deduced from the experimental data.

  3. Da Vinci-assisted abdominal cerclage.

    Barmat, Larry; Glaser, Gretchen; Davis, George; Craparo, Frank

    2007-11-01

    To report the first placement of an abdominal cervicoisthmic cerclage using the da Vinci robot. Case report. Tertiary-care hospital. A 39-year-old female with a history of cervical insufficiency who required a cerclage and was not a candidate for transvaginal cerclage placement. Abdominal cervicoisthmic cerclage placement using the da Vinci robot. Ability to safely and successfully place an abdominal cerclage using the da Vinci robot. Abdominal cerclage was successfully placed using the da Vinci robot. The patient had minimal blood loss and was discharged to home on the same day as surgery. Da Vinci robot-assisted abdominal cerclage placement is an innovative application of robotic surgery and may alter the standard of care for women who require this surgery.

  4. Recurrent oral angioleiomyoma

    V G Mahima

    2011-01-01

    Full Text Available Angioleiomyomas are vascular variant of leiomyomas which are benign tumors of smooth muscle. They are exceedingly rare in the oral cavity. Malignant transformation of these tumors has also been reported occasionally which warrants knowledge of this soft tissue tumor. A 57 year old male patient reported with a 15 day history of an asymptomatic growth that had started insidiously in his lower left back tooth region. Clinical examination revealed a solitary, oval, sessile growth in the mandibular left retro molar region. Excisional biopsy was suggestive of Angioleiomyoma. A recurrence of the same was noted two months later which was also histopathologically reported as Angioleiomyoma. The same was confirmed using special stains. This case reports an unusual presentation of Angioleiomyoma with regards to both recurrence as well as rapid growth. It is important to be well aware of this uncommon entity as these tumors often can mimic or transform into malignancy. Precise clinicopathological examinations are therefore invaluable in establishing an accurate diagnosis and delivering suitable treatment.

  5. The value of intra-abdominal pressure monitoring through ...

    hypertension after abdominal closure (8%) and only one of ... Ann Pediatr. Surg 13:69–73 c 2017 Annals of Pediatric Surgery. Annals of ... intra-abdominal hypertension ..... measurements as a guide in the closure of abdominal wall defects.

  6. Numerical Study on Hydrogen Flow Behavior in Two Compartments with Different Connecting Pipes

    HanChen Liu

    2017-01-01

    Full Text Available Hydrogen accumulation in the containment compartments under severe accidents would result in high concentration, which could lead to hydrogen deflagration or detonation. Therefore, getting detailed hydrogen flow and distribution is a key issue to arrange hydrogen removal equipment in the containment compartments. In this study, hydrogen flow behavior in local compartments has been investigated in two horizontal compartments. The analysis model is built by 3-dimensional CFD code in Cartesian coordinates based on the connection structure of the Advanced Pressurized Water Reactor (PWR compartments. It consists of two cylindrical vessels, representing the Steam Generator compartment (SG and Core Makeup Tank compartment (CMT. With standard k-ε turbulence model, the effects of the connecting pipe size and location on hydrogen concentration distribution are investigated. Results show that increasing the diameter of connection pipe (IP which is located at 800 mm from 150 mm to 300 mm facilitates hydrogen flow between compartments. Decreasing the length of IP which is located at 800 mm from 1000 mm to 500 mm can also facilitate hydrogen flow between compartments. Lower IP is in favor of hydrogen mixing with air in non-source compartment. Higher IP is helpful for hydrogen flow to the non-source term compartment from source term compartment.

  7. 46 CFR 171.017 - One and two compartment standards of flooding.

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false One and two compartment standards of flooding. 171.017... standards of flooding. (a) One compartment standard of flooding. A vessel is designed to a one compartment standard of flooding if the margin line is not submerged when the total buoyancy between each set of two...

  8. Acute compartment syndrome after muscle rupture in a non-athlete.

    Thennavan, A S; Funk, L; Volans, A P

    1999-01-01

    Acute compartment syndrome after muscle rupture, although rare, is a limb threatening condition, which warrants emergency treatment. The case of acute compartment syndrome secondary to a gastrocnemius muscle tear of the right lower leg, in a non-athlete is reported. To our knowledge, this is the only description of acute compartment syndrome due to muscle rupture in a non-athlete.

  9. Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?

    Ow, Lin Li; Lim, Yik N; Dwyer, Peter L; Karmakar, Debjyoti; Murray, Christine; Thomas, Elizabeth; Rosamilia, Anna

    2016-09-01

    The objective of this study was to assess outcomes in native tissue (NT) and transvaginal mesh (TVM) repair in women with recurrent prolapse. A retrospective two-group observational study of 237 women who underwent prolapse repair after failed NT repair in two tertiary hospitals. A primary outcome of "success" was defined using a composite outcome of no vaginal bulge symptoms, no anatomical recurrence in the same compartment beyond the hymen (0 cm on POPQ) and no surgical re-treatment for prolapse in the same compartment. Secondary outcomes assessed included re-operation for prolapse in the same compartment, dyspareunia and mesh-related complications. Of a total of 336 repairs, 196 were performed in the anterior compartment and 140 in the posterior compartment. Compared with the TVM groups, women undergoing repeat NT repair were more likely to experience anatomical recurrence (anterior 40.9 % vs 25 %, p = 0.02, posterior 25.3 % vs 7.5 %, p = 0.01), report vaginal bulge (anterior 34.1 % vs 12 %, p mesh exposure were 9.3 % anteriorly and 15.1 % posteriorly. Although the number of women requiring a prolapse re-operation is lower in the TVM group, the overall re-operation rate was not significantly different when procedures to correct mesh complications were included. Although the success rate is better with the use of TVM for recurrent prolapse, the total re-operation rates are similar when mesh complication-related surgeries are included.

  10. Leisure-time physical activity and intra-abdominal fat in young adulthood: A monozygotic co-twin control study.

    Rottensteiner, Mirva; Leskinen, Tuija; Järvelä-Reijonen, Elina; Väisänen, Karoliina; Aaltonen, Sari; Kaprio, Jaakko; Kujala, Urho M

    2016-05-01

    To investigate differences in abdominal fat compartments between young adult monozygotic twin pairs discordant for leisure-time physical activity. Ten young adult male monozygotic twin pairs (age range 32-36 years) discordant for leisure-time physical activity during the past 3 years were systematically selected from a population-based Finnish twin cohort. Magnetic resonance image at the level of the L2-L3 intervertebral disc was used to predict intra-abdominal and subcutaneous abdominal fat masses. Dietary intake was assessed with a 4-day food diary. Inactive twins had 31% more intra-abdominal fat than their active co-twins (mean difference 0.52 kg, 95% CI 0.12 to 0.91, P = 0.016), whereas the difference in subcutaneous abdominal fat was only 13% (P = 0.21) and 3% in body mass index (P = 0.28). Intraperitoneal fat mass was 41% higher among inactive twins compared to their active co-twins (mean difference 0.41 kg, 95% CI 0.11 to 0.70, P = 0.012). Dietary intake did not differ between co-twins. A lower level of physical activity is related to greater accumulation of intra-abdominal fat among healthy adult males in their mid-30s. The findings highlight the importance of leisure-time physical activity independent of genes and diet in the prevention of intra-abdominal fat accumulation from early adulthood onward. © 2016 The Obesity Society.

  11. Recurrent pregnancy loss

    Egerup, P; Kolte, A M; Larsen, E C

    2016-01-01

    STUDY QUESTION: Is there a different prognostic impact for consecutive and non-consecutive early pregnancy losses in women with secondary recurrent pregnancy loss (RPL)? SUMMARY ANSWER: Only consecutive early pregnancy losses after the last birth have a statistically significant negative prognostic...... impact in women with secondary RPL. WHAT IS KNOWN ALREADY: The risk of a new pregnancy loss increases with the number of previous pregnancy losses in patients with RPL. Second trimester losses seem to exhibit a stronger negative impact than early losses. It is unknown whether the sequence of pregnancy...... losses plays a role for the prognosis in patients with a prior birth. STUDY DESIGN, SIZE, DURATION: This retrospective cohort study of pregnancy outcome in patients with unexplained secondary RPL included in three previously published, Danish double-blinded placebo-controlled trials of intravenous...

  12. Recurrent Spatial Transformer Networks

    Sønderby, Søren Kaae; Sønderby, Casper Kaae; Maaløe, Lars

    2015-01-01

    We integrate the recently proposed spatial transformer network (SPN) [Jaderberg et. al 2015] into a recurrent neural network (RNN) to form an RNN-SPN model. We use the RNN-SPN to classify digits in cluttered MNIST sequences. The proposed model achieves a single digit error of 1.5% compared to 2.......9% for a convolutional networks and 2.0% for convolutional networks with SPN layers. The SPN outputs a zoomed, rotated and skewed version of the input image. We investigate different down-sampling factors (ratio of pixel in input and output) for the SPN and show that the RNN-SPN model is able to down-sample the input...

  13. Recurrent Aggressive Angiomyxoma*

    Suelene Suassuna Silvestre de Alencar

    2013-10-01

    Full Text Available Introduction: aggressive angiomyxoma is a highly aggressive, rare neoplasm of the mesen- chymal tissue with a high recurrence rate. It represents an important differential diagnosis of pelvic tumors in women of reproductive age. This study aims to describe a case of ag- gressive angiomyxoma.Case report: woman, 37 years old, complained about a bulge on the right perianal region, and anal itching and burning, bleeding, tenesmus and incontinence. The proctologic examina- tion confirmed the perianal bulge and extrinsic compression of the posterior wall of the rectum. Computed tomography (CT of the pelvis showed a well-defined pelvic mass ex- tending to the right rectal area. Exploratory laparotomy showed a mass of fibro elastic con- sistency adjacent to the pelvic organs and closely attached to the distal rectum, and per- formed a resection of the pelvic tumor afterward. Anatomopathological analysis revealed an aggressive angiomyxoma. Magnetic resonance imaging (MRI of the pelvis showed signs of recurrence in the pelvic cavity on the right side of the rectum. A surgical procedure was performed to resect the lesion. After an asymptomatic period, the MRI showed solid growths located in the right ischiorectal fossa. A new surgical procedure identified only retention cysts in the pelvis and right ischiorectal fossa, only lysis of adhesions was per- formed. The patient is currently undergoing follow-up without disease recurrence. Resumo: Introdução: o angiomixoma agressivo é uma rara neoplasia do tecido mesenquimal de gran- de agressividade e alta taxa de recorrência. Representa um importante diagnóstico diferen- cial de tumorações pélvicas de mulheres em idade reprodutiva. Este estudo objetiva relatar um caso de angiomixoma agressivo.Relato de caso: mulher, 37 anos, com queixa de abaulamento em região perianal direita, além de prurido e ardor anal, sangramento, tenesmo e incontinência anal. Exame procto- lógico confirmou o abaulamento

  14. Analysis of Brain Recurrence

    Frilot, Clifton; Kim, Paul Y.; Carrubba, Simona; McCarty, David E.; Chesson, Andrew L.; Marino, Andrew A.

    Analysis of Brain Recurrence (ABR) is a method for extracting physiologically significant information from the electroencephalogram (EEG), a non-stationary electrical output of the brain, the ultimate complex dynamical system. ABR permits quantification of temporal patterns in the EEG produced by the non-autonomous differential laws that govern brain metabolism. In the context of appropriate experimental and statistical designs, ABR is ideally suited to the task of interpreting the EEG. Present applications of ABR include discovery of a human magnetic sense, increased mechanistic understanding of neuronal membrane processes, diagnosis of degenerative neurological disease, detection of changes in brain metabolism caused by weak environmental electromagnetic fields, objective characterization of the quality of human sleep, and evaluation of sleep disorders. ABR has important beneficial implications for the development of clinical and experimental neuroscience.

  15. Dynamic CT in the abdominal organ, 1

    Fukuda, Kunihiko

    1980-01-01

    By utilizing a 4.5-second CT (computed tomography) scanner which allows sequential scans the changes of the iodine concentration in abdominal organs can be observed as dynamics reflected in CT number. The abdominal dynamic CT was performed as following method. After performing the preliminary scan 50ml of 60% meglumine iothalamate was rapidly injected intravenously by hands. The sequential scanning was initiated when a half dose of contrast medium was injected. In completion of the 4 sequential scans under arrested respiration the conventional post contrast scanning was performed. The analysis of 112 cases dynamically studied by CT came to the following conclusion. CT number of the abdominal aorta was greatest on the 1st or 2nd scan of the sequential scans (7.5 - 20.5 seconds after initiation of injection). Following this peak formation, CT number of the abdominal aorta declined rapidly due to both prompt diffusion of contrast medium into the extravascular space and dilution by the intravascular fluid. Iodine concentration of the abdominal aorta during the peak period was calculated as 11.3 mg/ml by the present method, being theoretically sufficient for delineation of the vessels smaller than medium size. In the patients with impaired renal function, several characteristic patterns were noted on the dynamics of contrast medium within the abdominal organs. The abdominal dynamic CT was felt to be promissing for evaluation of the renal function. (author)

  16. Review article: the functional abdominal pain syndrome.

    Sperber, A D; Drossman, D A

    2011-03-01

    Functional abdominal pain syndrome (FAPS) is a debilitating disorder with constant or nearly constant abdominal pain, present for at least 6 months and loss of daily functioning. To review the epidemiology, pathophysiology and treatment of FAPS. A literature review using the keywords: functional abdominal pain, chronic abdominal pain, irritable bowel syndrome and functional gastrointestinal disorders. No epidemiological studies have focused specifically on FAPS. Estimates of prevalence range from 0.5% to 1.7% and tend to show a female predominance. FAPS pathophysiology appears unique in that the pain is caused primarily by amplified central perception of normal visceral input, rather than by enhanced peripheral stimulation from abdominal viscera. The diagnosis of FAPS is symptom-based in accordance with the Rome III diagnostic criteria. These criteria are geared to identify patients with severe symptoms as they require constant or nearly constant abdominal pain with loss of daily function and are differentiated from IBS based on their non-association with changes in bowel habit, eating or other gut-related events. As cure is not feasible, the aims of treatment are reduced suffering and improved quality of life. Treatment is based on a biopsychosocial approach with a therapeutic patient-physician partnership at its base. Therapeutic options include central nonpharmacological and pharmacological modalities and peripheral modalities. These can be combined to produce an augmentation effect. Although few studies have assessed functional abdominal pain syndrome or its treatment specifically, the treatment strategies outlined in this paper appear to be effective. © 2011 Blackwell Publishing Ltd.

  17. Radiologic findings of abdominal wall endometriosis

    Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2003-12-01

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.

  18. Radiologic findings of abdominal wall endometriosis

    Seo, Jung Wook

    2003-01-01

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer

  19. Recurrence of gastric dilatation-volvulus after incisional gastropexy in a rottweiler.

    Hammel, Scott P; Novo, Roberto E

    2006-01-01

    An adult, castrated male rottweiler with a history of gastric dilatation-volvulus (GDV), which was treated 4 months previously by surgical gastric resection and incisional gastropexy, had a recurrence of clinical signs. Abdominal exploratory surgery revealed a 180 degrees -clockwise GDV, with a stretched adhesion at the original gastropexy site. The stomach was repositioned, and additional gastropexies were performed adjacent to the original gastropexy site and at the gastric fundus. The recurrence of GDV in this dog with an intact gastropexy suggested that a risk for volvulus remains after therapeutic incisional gastropexy.

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

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

  1. Treatment strategy for ruptured abdominal aortic aneurysms.

    Davidovic, L

    2014-07-01

    Rupture is the most serious and lethal complication of the abdominal aortic aneurysm. Despite all improvements during the past 50 years, ruptured abdominal aortic aneurysms are still associated with very high mortality. Namely, including patients who die before reaching the hospital, the mortality rate due to abdominal aortic aneurysm rupture is 90%. On the other hand, during the last twenty years, the number of abdominal aortic aneurysms significantly increased. One of the reasons is the fact that in majority of countries the general population is older nowadays. Due to this, the number of degenerative AAA is increasing. This is also the case for patients with abdominal aortic aneurysm rupture. Age must not be the reason of a treatment refusal. Optimal therapeutic option ought to be found. The following article is based on literature analysis including current guidelines but also on my Clinics significant experience. Furthermore, this article show cases options for vascular medicine in undeveloped countries that can not apply endovascular procedures at a sufficient level and to a sufficient extent. At this moment the following is evident. Thirty-day-mortality after repair of ruptured abdominal aortic aneurysms is significantly lower in high-volume hospitals. Due to different reasons all ruptured abdominal aortic aneurysms are not suitable for EVAR. Open repair of ruptured abdominal aortic aneurysm should be performed by experienced open vascular surgeons. This could also be said for the treatment of endovascular complications that require open surgical conversion. There is no ideal procedure for the treatment of AAA. Each has its own advantages and disadvantages, its own limits and complications, as well as indications and contraindications. Future reductions in mortality of ruptured abdominal aortic aneurysms will depend on implementation of population-based screening; on strategies to prevent postoperative organ injury and also on new medical technology

  2. Extralevator Abdominal Perineal Excision Versus Standard Abdominal Perineal Excision: Impact on Quality of the Resected Specimen and Postoperative Morbidity.

    Habr-Gama, Angelita; São Julião, Guilherme P; Mattacheo, Adrian; de Campos-Lobato, Luiz Felipe; Aleman, Edgar; Vailati, Bruna B; Gama-Rodrigues, Joaquim; Perez, Rodrigo Oliva

    2017-08-01

    Abdominal perineal excision (APE) has been associated with a high risk of positive circumferential resection margin (CRM+) and local recurrence rates in the treatment of rectal cancer. An alternative extralevator approach (ELAPE) has been suggested to improve the quality of resection by avoiding coning of the specimen decreasing the risk of tumor perforation and CRM+. The aim of this study is to compare the quality of the resected specimen and postoperative complication rates between ELAPE and "standard" APE. All patients between 1998 and 2014 undergoing abdominal perineal excision for primary or recurrent rectal cancer at a single Institution were reviewed. Between 1998 and 2008, all patients underwent standard APE. In 2009 ELAPE was introduced at our Institution and all patients requiring APE underwent this alternative procedure (ELAPE). The groups were compared according to pathological characteristics, specimen quality (CRM status, perforation and failure to provide the rectum and anus in a single specimen-fragmentation) and postoperative morbidity. Fifty patients underwent standard APEs, while 22 underwent ELAPE. There were no differences in CRM+ (10.6 vs. 13.6%; p = 0.70) or tumor perforation rates (8 vs. 0%; p = 0.30) between APE and ELAPE. However, ELAPE were less likely to result in a fragmented specimen (42 vs. 4%; p = 0.002). Advanced pT-stage was also a risk factor for specimen fragmentation (p = 0.03). There were no differences in severe (Grade 3/4) postoperative morbidity (13 vs. 10%; p = 0.5). Perineal wound dehiscences were less frequent among ELAPE (52 vs 13%; p < 0.01). Despite short follow-up (median 21 mo.), 2-year local recurrence-free survival was better for patients undergoing ELAPE when compared to APE (87 vs. 49%; p = 0.04). ELAPE may be safely implemented into routine clinical practice with no increase in postoperative morbidity and considerable improvements in the quality of the resected specimen of patients with low rectal

  3. Pericardial effusion and pericardial compartments after open heart surgery

    Duvernoy, O.; Larsson, S.G.; Persson, K.; Thuren, J.; Wikstroem, G.; Akademiska Sjukhuset, Uppsala; Akademiska Sjukhuset, Uppsala

    1990-01-01

    Thirty-three patients with pericardial effusion after open heart surgery were investigated with computed tomography (CT). Twelve of the 33 patients also underwent echocardiography prior to pericardiocentesis. The effusions were typed according to the results of the CT investigation. Because of postoperative adhesions, typical patterns of localized pericardial effusions were found in 16 patients. The localized compartments were seen on the right and left side of the heart and around the aorta and the pulmonary artery. CT was therefore shown to be of value for selecting the approach for drainage with catheter pericardiocentesis. (orig.)

  4. Modeling fires in adjacent ship compartments with computational fluid dynamics

    Wix, S.D.; Cole, J.K.; Koski, J.A.

    1998-01-01

    This paper presents an analysis of the thermal effects on radioactive (RAM) transportation pack ages with a fire in an adjacent compartment. An assumption for this analysis is that the adjacent hold fire is some sort of engine room fire. Computational fluid dynamics (CFD) analysis tools were used to perform the analysis in order to include convective heat transfer effects. The analysis results were compared to experimental data gathered in a series of tests on the United States Coast Guard ship Mayo Lykes located at Mobile, Alabama. (authors)

  5. Containment shells of reactor compartments at foreign NPPs

    Demidov, A.P.; Savchenko, V.A.

    1989-01-01

    The modern designes of containment shells (CS) of NPP reactor compartments is described. Much attention is paid to the PCS-3 project envisaging CS inclusion in the complex of NPP passive safety system. The PCS-3 system is developed in the USA for NPP with the improved PWR type reactor. The above system permits to cool the core quickly, to reduce steam pressure in CS down to a safe level and to prevent the discharge of radioactive products in the atmosphere in the case of accidents, even very serious, caused by loss of coolant and core dryout

  6. A two-compartment exposure device for foliar uptake study

    Zuo, Q.; Lin, H.; Zhang, X.L.; Li, Q.L.; Liu, S.Z.; Tao, S.

    2006-01-01

    An airtight two-chamber exposure devise was designed for investigating foliar uptake of polycyclic aromatic hydrocarbons (PAHs) by plants. The upper and the bottom chambers of the device were air-tightly separated by an aluminum foil and the plant aerial tissues and roots were exposed in the two chambers, respectively. The device was tested using maize exposed to several PAH species. Positive correlations between air and aerial tissue concentrations of the exposed PAH species were revealed. PAHs spiking in the culture solution had no influence on the leaf concentrations. -- A two-compartment gastight exposure device was developed for investigation of foliar uptake of PAHs by plants

  7. Arthroscopic meniscectomy in medial compartment osteoarthritis of the knee

    Noguchi, Joji; Shimoyama, Gishichiro; Shinozaki, Toshiro; Nagata, Kensei

    2007-01-01

    The purpose of this research is to evaluate the results of arthroscopic meniscectomy in medial compartment osteoarthritis of the knee. The operation was performed on 25 knee joints (8 male, 17 female) with the mean age of 67 years. The mean period of follow-up was 19 months. Clinical results were more or less excellent, but radiological assessment suggested slight osteoarthritic changes. In addition, two cases progressed to subchondral bone collapse. Of 12 cases which had no bone marrow edema on MRI before surgery, six (50%) cases showed it at follow-up. These findings suggest a possible relationship between arthroscopic meniscectomy and later appearance of osteonecrosis in some cases. (author)

  8. Recurrent pyogenic cholangitis in Asian immigrants: use of ultrasonography, computed tomography, and cholangiography

    Federle, M.P.; Cello, J.P.; Laing, F.C.; Jeffery, R.B. Jr.

    1982-01-01

    Five cases of recurrent pyogenic cholangitis (RPC) were studied by ultrasonography, computed tomography (CT), and cholangiography. All patients were recent immigrants from the Orient or Indonesia and had had recurrent attacks of cholangitis for many years. The bile was infected by E. coli and the biliary ducts were dilated; in addition, extrahepatic bile-pigment calculi we represent in all 5 and intrahepatic calculi in 4. Abdominal ultrasound usually failed to demonstrate duct calculi and extrahepatic dilatation due to the soft, mud-like consistency of the stones. CT was successful in showing the calculi and the full extent of dilatation. The authors conclude that preoperative diagnosis of RPC is best achieved by awareness of the characteristic clinical presentation and the findings on abdominal CT. Preoperative cholangiography provides excellent detail, but poses the danger of biliary sepsis requiring antibiotics

  9. Diagnosis of calcification on abdominal radiographs

    Lamb, C.R.; Kleine, L.J.; McMillan, M.C.

    1991-01-01

    A wide variety of normal and pathologic factors may induce intraabdominal calcification. In general, the most reliable indication of the cause of a calcification is its location; therefore, if the affected organ can be identified the radiographic diagnosis is often straightforward or, at least, limited to relatively few possibilities. With this principle in mind, a series of patients with abdominal calcification are described for the purpose of illustrating the appearance of calcification of various abdominal organs. In addition, etiology for the calcification in each patient is discussed. Certain extraabdominal calcifications which may be seen on abdominal radiographs are also mentioned

  10. Computerized abdominal tomography in Wilson's disease

    Tsuchikura, Keiko; Ogawa, Teruyuki; Nakajima, Akihisa; Ono, Yasuhiko

    1986-05-01

    Cranial and abdominal computerized tomography (CT) was performed in a 10-year-old boy with Wilson's disease complicated by liver cirrhosis. Abdominal CT showed diffuse high density areas over the whole part of the liver propably due to copper sediments, although there was no abnormal cranial CT findings. Decreased high density area of the liver was seen 60 days after the administration of D-penicillamine, suggesting the excretion of copper from the liver. Abdominal CT, as well as cranial CT, may be of help to diagnose Wilson's disease and evaluate therapeutic effects. (Namekawa, K.).

  11. Roentgenologic evaluation of blunt abdominal trauma

    Lee, Yong Zoon; Ra, Woo Youn; Woo, Won Hyung [Hankang Sacred heart Hospital, Chung Ang University School of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    This study comprises 25 cases of blunt abdominal trauma proved by surgery. It is concluded that visceral damage by blunt abdominal trauma may be suspected, but can not be satisfactorily diagnosed upon a single plane abdominal roentgenologic examination with clinical support. Contrary to some reports in the literature, rupture of the hallow, viscus is more susceptible than solid organ and ileum is more than jejunum. It is a useful roentgenologic sign denoting distension and small cresent air shadow in the duodenal sweep of the damaged pancreas.

  12. Cranial radiotherapy predisposes to abdominal adiposity in survivors of childhood acute lymphocytic leukemia

    Siviero-Miachon, Adriana Aparecida; Spinola-Castro, Angela Maria; Lee, Maria Lúcia de Martino; Andreoni, Solange; Geloneze, Bruno; Lederman, Henrique; Guerra-Junior, Gil

    2013-01-01

    Advances in treatment of acute lymphocytic leukemia increased the likelihood of developing late treatment-associated effects, such as abdominal adiposity, increasing the risk of cardiovascular disease in this population. Cranial radiotherapy is one of the factors that might be involved in this process. The aim of this study was to determine the effect of cranial radiotherapy on adiposity indexes in survivors of acute lymphocytic leukemia. A comparative cross-sectional study of 56 acute lymphocytic leukemia survivors, chronological age between 15 and 24 years, assigned into two groups according to the exposure to cranial radiotherapy (25 irradiated and 31 non-irradiated), assessed according to body fat (dual energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, lipid profile, and insulin resistance. Cranial radiotherapy increased body fat and abdominal adipose tissue and altered lipid panel. Yet, lipids showed no clinical relevance so far. There were significantly more obese patients among those who received cranial radiotherapy (52% irradiated versus 22.6% non-irradiated), based on dual energy X-ray absorptiometry body fat measurements. Nonetheless, no association was observed between cranial radiotherapy and body mass index, waist circumference, waist-to-height ratio or insulin resistance. Adolescent and young adult survivors of childhood acute lymphocytic leukemia showed an increase in body fat and an alteration of fat distribution, which were related to cranial radiotherapy. Fat compartment modifications possibly indicate a disease of adipose tissue, and cranial radiotherapy imports in this process

  13. Abdominal and perineal approaches in the surgical treatment of rectal prolapse

    Mesut Gül

    2012-03-01

    Full Text Available Introduction: Rectal prolapse is a disease, which is an important cause of social and functional problems and has a continuing debate about the ideal surgical treatment of itself. In this study, we aimed to investigate the abdominal and perineal approaches with early and late postoperative result in the patients undergoing surgery for rectal prolapse.Materials and methods: Between 2006-2011, the records of 21 patients undergoing surgery with the diagnosis of rectal prolapse were reviewed, retrospectively. The demographic and physical examination findings, surgical procedures, early and late postoperative complications, recurrence and mortality rates were recorded.Results: The median age was 43 years and female/male ratio was 1.63/1. The most common presenting complaint was gas control failure and often wetting with mucus. Stage 1 and stage 3 rectal prolapses was detected in 19% and 81% of the patients, respectively. The most common surgical procedure was Notaras (54%. Early postoperative complications were seen in 14.3% of the patients. There were no postoperative recurrence, mortality and complication requiring re-exploration. Advanced age and shorter duration of hospital stay were determined and often performed under regional anesthesia in the patients undergoing perineal approach. No statistical differences were observed in terms of early postoperative complications and recurrence.Conclusion: Results of abdominal and perineal approaches were similar, when they were applied with taking into account the risk factors for surgical treatment, findings of the patients and the surgeon’s experience.

  14. Errors in abdominal computed tomography

    Stephens, S.; Marting, I.; Dixon, A.K.

    1989-01-01

    Sixty-nine patients are presented in whom a substantial error was made on the initial abdominal computed tomography report. Certain features of these errors have been analysed. In 30 (43.5%) a lesion was simply not recognised (error of observation); in 39 (56.5%) the wrong conclusions were drawn about the nature of normal or abnormal structures (error of interpretation). The 39 errors of interpretation were more complex; in 7 patients an abnormal structure was noted but interpreted as normal, whereas in four a normal structure was thought to represent a lesion. Other interpretive errors included those where the wrong cause for a lesion had been ascribed (24 patients), and those where the abnormality was substantially under-reported (4 patients). Various features of these errors are presented and discussed. Errors were made just as often in relation to small and large lesions. Consultants made as many errors as senior registrar radiologists. It is like that dual reporting is the best method of avoiding such errors and, indeed, this is widely practised in our unit. (Author). 9 refs.; 5 figs.; 1 tab

  15. Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain

    Ming-Ta Tsai

    2017-01-01

    Full Text Available Lead poisoning (LP is less commonly encountered in emergency departments (ED. However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.

  16. Immunoscintigraphy of recurrences of gynecologic carcinomas

    Chatal, J.F.; Fumoleau, P.; Saccavini, J.C.

    1987-01-01

    In a first, retrospective study, 15 patients with known ovarian carcinoma were injected with 131 I-OC 125 F(ab')2 monoclonal antibody (MAb). The sensitivity of immunoscintigraphy based on the number of the tumor sites was 67% (12/18). In a second, prospective study, 29 patients with gynecologic carcinoma were injected with 131 I-OC 125 F(ab')2 (24) or 131 I-19-9 F(ab')2 (5) MAbs according to the histologic type. Based on the number of tested anatomic sites, sensitivity was 72% and specificity 86%. In two patients injected with both 131 I-OC-125 F(ab')2 and 125 I-NS F(ab')2 (nonspecific immunoglobulin) 1 and 4 days before tumor resection, tumor uptake of the specific antibody was 2.2 and 4.5 times greater than that of NS. Immunoscintigraphic results were complementary with those of ultrasonography and computed tomography. Finally, in one patient injected successively with 131 I-OC 125 F(ab')2 and 111 In-DTPA-OC 125 F(ab')2, the recurrent tumor was visualized with both radionuclides, with 111 In providing better abdominal tumor contrast but causing much greater liver radioactivity than 131 I

  17. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer

    Pellizzon, Antonio Cassio Assis, E-mail: acapellizzon@hcancer.org.br [A.C. Camargo Cancer Center, Sao Paulo, SP (Brazil). Departamento de Radioterapia

    2016-05-15

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. (author)

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

    John E. Lawrence

    2016-01-01

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

  19. Shock absorber system for nuclear reactor ice condenser compartment

    Meier, J.F.; Rudd, G.E.; Pradhan, A.V.; George, J.A.; Lippincott, H.W.; Sutherland, J.D.

    1979-01-01

    A shock absorber system was designed to absorb the energy imparted to doors in a nuclear reactor ice condenser compartment as they swing rapidly to an open position. Each shock absorber which is installed on a wall adjacent to each door is large and must absorb up to about 40,000 foot pounds of energy. The basic shock absorber component comprises foam enclosed in a synthetic fabric bag having a volume about twice the foam volume. A stainless steel knitted mesh bag of the same volume as the fabric bag, contains the fabric bag and its enclosed foam. To protect the foam and bags during construction activities at the reactor site and from the shearing action of the doors, a protective sheet metal cover is installed over the shock absorber ends and the surface to be contacted by the moving door. With the above shock absorber mounted on a wall behind each door, as the door is forcibly opened by steam pressure and air resulting from a pipe break in the reactor compartment, it swings at a high velocity into contact with the shock absorber, crushes the foam and forces it into the fabric bag excess material thus containing the foam fragmented particles, and minimizes build-up of pressure in the bag as a result of the applied compressive force

  20. Involvement of the mitochondrial compartment in human NCL fibroblasts

    Pezzini, Francesco; Gismondi, Floriana; Tessa, Alessandra; Tonin, Paola; Carrozzo, Rosalba; Mole, Sara E.; Santorelli, Filippo M.; Simonati, Alessandro

    2011-01-01

    Highlights: ► Mitochondrial reticulum fragmentation occurs in human CLN1 and CLN6 fibroblasts. ► Likewise mitochondrial shift-to periphery and decreased mitochondrial density are seen. ► Enhanced caspase-mediated apoptosis occurs following STS treatment in CLN1 fibroblasts. -- Abstract: Neuronal ceroid lipofuscinosis (NCL) are a group of progressive neurodegenerative disorders of childhood, characterized by the endo-lysosomal storage of autofluorescent material. Impaired mitochondrial function is often associated with neurodegeneration, possibly related to the apoptotic cascade. In this study we investigated the possible effects of lysosomal accumulation on the mitochondrial compartment in the fibroblasts of two NCL forms, CLN1 and CLN6. Fragmented mitochondrial reticulum was observed in all cells by using the intravital fluorescent marker Mitotracker, mainly in the perinuclear region. This was also associated with intense signal from the lysosomal markers Lysotracker and LAMP2. Likewise, mitochondria appeared to be reduced in number and shifted to the cell periphery by electron microscopy; moreover the mitochondrial markers VDCA and COX IV were reduced following quantitative Western blot analysis. Whilst there was no evidence of increased cell death under basal condition, we observed a significant increase in apoptotic nuclei following Staurosporine treatment in CLN1 cells only. In conclusion, the mitochondrial compartment is affected in NCL fibroblasts invitro, and CLN1 cells seem to be more vulnerable to the negative effects of stressed mitochondrial membrane than CLN6 cells.