scholarly journals Colonic Diverticulosis: From Asymptomatic Form to Major Complications

2018 ◽  
Vol 15 (2) ◽  
pp. 27-30
Author(s):  
Ana Maria Miulescu ◽  
Alexandru Ispas
Keyword(s):  
Computed Tomography ◽  
Bowel Obstruction ◽  
Medical Records ◽  
Acute Abdominal Pain ◽  
Geographical Area ◽  
Secondary Peritonitis ◽  
Abdominal Radiograph ◽  
Colonic Diverticulosis ◽  
Different Types ◽  
Surgery Department

AbstractIntroduction This pathology is rare in patients younger than 40 years old (5%) and, in those older than 70 years old, almost 50% exhibit colonic diverticulosis. Most cases have mild symptoms and only 20% presents complications as: bleeding, bowel obstruction, abscess and secondary peritonitis.Aim. The aim is to analyse different types of complications in colonic diverticulosis and compare the data from literature to those in Argeș geographical area.Material and method. The medical records of 120 patients out of which 101 were admitted in gastroenterology department and 19 in general surgery department were analysed. Diagnosis methods: colonoscopy, computed tomography with contrast dye, simple abdominal radiograph for acute abdominal pain.Results. 40 patients (33.33%) with asymptomatic colonic diverticulosis, 28 patients (23.33%) moderate diverticulitis, 25 patients (20.83%) with moderate anorectal bleeding, 25 patients (20.83%) with secondary peritonitis, and 2 (1.68%) cases with complications.Conclusions. All the patients were older than 50 years old, 44 % of diverticulitis cases led to complications (almost half with bleeding and the rest with peritonitis). No bowel obstruction. In 99% of the cases, the localisation of the diverticula was at the level of sigmoid and descending colon.

Accuracy of Computed Tomography in Small Bowel Obstruction

2013 ◽  
Vol 79 (6) ◽  
pp. 641-643 ◽  
Author(s):  
Rebecca E. Barnett ◽  
Jason Younga ◽  
Brady Harris ◽  
Robert C. Keskey ◽  
Daryl Nisbett ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Retrospective Chart Review ◽  
Clinical Findings ◽  
Abdominal Radiograph ◽  
Plain Abdominal Radiograph ◽  
Ischemic Bowel

Small bowel obstruction is a common clinical occurrence, primarily caused by adhesions. The diagnosis is usually made on the clinical findings and the presence of dilated bowel loops on plain abdominal radiograph. Computed tomography (CT) is increasingly used to diagnose the cause and location of the obstruction to aid in the timing of surgical intervention. We used a retrospective chart review to identify patients with a diagnosis of small bowel obstruction between 2009 and 2012. We compared the findings on CT with the findings at operative intervention. Sixty patients had abdominal CT and subsequent surgical intervention. Eighty-three per cent of CTs were correct for small intestine involvement and 80 per cent for colon involvement. The presence of adhesions or perforation was correctly identified in 21 and 50 per cent, respectively. Sixty-four per cent correctly identified a transition point. The presence of a mass was correctly identified in 69 per cent. Twenty per cent of the patients who had ischemic small bowel at surgery were identified on CT. CT has a role in the clinical assessment of patients with small bowel obstruction, identifying with reasonable accuracy the extent of bowel involvement and the presence of masses and transition points. It is less reliable at identifying adhesions, perforations, or ischemic bowel.

Morbidity of in-hospital purulent-septic infections of adults patients after different types of endovascular cardiosurgical operations

2020 ◽  
pp. 13-19
Author(s):  
Viktor Ivanovich Sergevnin ◽  
Larisa Gennadievna Kudryavtseva ◽  
Anna Igorevna Zolotukhina
Keyword(s):  
Medical Records ◽  
Heart Surgery ◽  
Surgical Intervention ◽  
Heart Rhythm ◽  
Community Acquired Pneumonia ◽  
Short Term ◽  
Intervention Community ◽  
Duration Of Surgery ◽  
Different Types ◽  
Low Incidence

An estimate of the incidence of nosocomial purulent-septic infections (GSI) of adult patients after various types of closed heart surgery according to the results of a study of medical records of 3275 patients is presented. It was established that the incidence rate of typical GSI after endovascular cardiac surgery was 3.1, with prenosological forms — 3.9 per 1000 operations. The main clinical options for postoperative GSI were infections in the field of surgical intervention, community-acquired pneumonia, urinary tract infection and bloodstream infection. There were no statistically significant differences between the incidence of GSI after stenting of the coronary arteries, operations for heart rhythm disturbances, stenosis of the carotid artery and other operations. The low incidence of GSI after closed heart surgery is due to the short duration of surgery, as well as the absence or short-term resuscitation of patients.

Do star employees help or hinder department performance: the case of surgeons in South Korean hospitals

2021 ◽  
pp. 1-16
Author(s):  
Sangsuk Oh ◽  
Owwon Park ◽  
Woonki Hong
Keyword(s):  
Positive Relationship ◽  
Surgical Patients ◽  
Healthcare Outcomes ◽  
Capital Theory ◽  
Research And Practice ◽  
South Korean ◽  
Strategic Human Capital ◽  
Different Types ◽  
Surgery Department ◽  
The Relationship

Abstract Based on strategic human capital theory, this study examines the effects of star surgeons on two different types of healthcare outcomes (i.e., number of surgical patients and length of patients’ in-hospital stay after surgery) in the surgery department. We also explore whether the relationship between star surgeons and healthcare outcomes is contingent on the expertise disparity between star and non-star surgeons. The results of an empirical analysis on colorectal cancer surgeons in 80 departments in South Korean hospitals show that the number of star surgeons increases the number of surgical patients and reduces the length of patients' stay after surgery. Moreover, the positive relationship between star surgeons and the number of surgical patients is strengthened when the expertise disparity between star and non-star surgeons is low. The implications of these findings for research and practice are also discussed.

Approach to the Patient with Abdominal Pain

2020 ◽  
Author(s):  
Dana Sajed
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Chronic Conditions ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Abdominal Ultrasonography ◽  
Pediatric Populations ◽  
Ed Visits ◽  
Point Of Care Ultrasonography

Abdominal pain is the most common presenting complaint in the emergency department (ED), accounting for nearly 8% of ED visits. Although many chronic conditions may cause pain in the abdomen, acute abdominal pain, defined as undiagnosed pain present for less than 1 week, is of greatest concern to the emergency practitioner. For many reasons, acute abdominal pain is often diagnostically challenging. Abdominal pain may be due to numerous causes, including gastrointestinal, genitourinary, cardiovascular, pulmonary, and other sources. Symptoms may fluctuate or change in nature, and the quality of pain can be difficult for the patient to describe. Physical examination findings, although important, are variable and can even be misleading. Despite being such a common presenting complaint, misdiagnosis is not uncommon and results in a high percentage of medicolegal actions in both and adult and pediatric populations. This review contains 5 figures, 8 tables, and 92 references Key words: abdominal computed tomography, abdominal pain, abdominal ultrasonography, pain management, point-of-care ultrasonography

scholarly journals SMALL BOWEL OBSTRUCTION SECONDARY TO OBTURATOR HERNIA: A PRE-OPERATIVE DIAGNOSIS AT COMPUTED TOMOGRAPHY

2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Marlina Tanty Ramli ◽  
Mohd Shukry Mohd Khalid ◽  
Kartini Rahmat
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Obturator Hernia ◽  
Uneventful Recovery ◽  
Presenting Symptoms

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.

scholarly journals Comparative Analysis of Capabilities of Different Types of Cone-Beam Tomography in an Experimental Study of Root Canals of Teeth Filled with High-Density Materials (part 2)

2021 ◽  
pp. 51-61
Author(s):  
A. Yu. Vasil'ev ◽  
V. V. Petrovskaya ◽  
E. A. Nichipor ◽  
V. G. Alpatova ◽  
N. N. Potrakhov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Experimental Study ◽  
Cone Beam Computed Tomography ◽  
Comparative Assessment ◽  
High Density ◽  
Cone Beam ◽  
Root Canals ◽  
Different Types ◽  
Before And After ◽  
Cone Beam Tomography

During the course of this experimental study tomograms of extracted teeth were analyzed before and after filling the root canals with an endodontic material and fragments of broken metal instruments for root canal treatment. During the first stage of the experiment, untreated extracted teeth were scanned using conebeam computed tomography and microfocus cone-beam computed tomography. A comparative assessment of capabilities of the two methods of cone-beam computed tomography based on examination of untreated root canals was carried out. The second part of the study is dedicated to visualization of root canals that contain foreign high-density materials.

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

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