Rational use of CT-scanner Considering its Diagnostic Accuracy for the Management of Acute Abdomen: A single-Center Study

Aim: We aimed to put forward the efficacy of abdominal CT performed for patients diagnosed with acute abdomen and to share our clinical findings in that regard. Methods: 216 patients who had been hospitalized in General Surgery Department due to acute abdomen had been analyzed retrospectively between October 2018 - January 2019. Abdominal computerized tomography (CT) results had been discussed in terms of diagnostic accuracy and clinical outcomes. Results: 171 (79.2%) patients (M/F:95/76 (55.6% / 44.4%)) had been evaluated by computerized tomography (CT) due to various causes of acute abdomen. Patients who had been scanned more than once (n=13 (7.6%)) during theirs’ hospitalization period had longer average length of stays compared to those whom had been scanned for only once (n=158 (92.4%)) (multiple scanned:17 days vs single scanned:3 days; p=0.000). Besides, single-scanned patients had showed higher clinical accuracy compared to those with multi-scans (80.4% vs 61.5%, p=0.126). 28 ileus (84.8%) patients had been scanned by non-enteral computerized tomography (CT), and 12 (36.4%) of them had been given false radiological reviews. Conclusion: Improper and redundant use of computerized tomography (CT) may cause prolongation of stays at the hospital, besides performing unnecessary scans do not improve diagnostic accuracy.

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Hyperthermia catheter implantation and therapy in the brain

Journal of Neurosurgery ◽

10.3171/jns.1990.72.6.0975 ◽

1990 ◽

Vol 72 (6) ◽

pp. 975-979 ◽

Cited By ~ 12

Author(s):

J. Alexander Marchosky ◽

Christopher J. Moran ◽

Neal E. Fearnot ◽

Charles F. Babbs

Keyword(s):

Computerized Tomography ◽

Malignant Gliomas ◽

Twist Drill ◽

Ct Scanner ◽

Tumor Blood Flow ◽

Content Type ◽

Catheter Implantation ◽

Computer Controlled ◽

Drill Holes ◽

The Brain

✓ For the treatment of malignant gliomas, a technique for implanting hyperthermia catheters was developed that utilized a stereotactic template and head-stabilization frame mounted on a computerized tomography (CT) scanner. Computerized tomography scans were used to measure tumor dimensions and to determine the number, implantation depths, and active heating lengths of the catheters, which were implanted through twist-drill holes while the patient was in the CT room. Heat was subsequently delivered via implanted catheters using a computer-controlled hyperthermia system, which partially compensates for heterogeneous and time-varying tumor blood flow.

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A Rare Cause of Mechanical Intestinal Obstruction: A Neoplastic Intra-Abdominal Testis

International Surgery ◽

10.9738/intsurg-d-15-00141.1 ◽

2016 ◽

Vol 101 (3-4) ◽

pp. 167-170

Author(s):

Fatih Ciftci ◽

Suat Benek ◽

Cem Kezer

Keyword(s):

Intestinal Obstruction ◽

Acute Abdomen ◽

Undescended Testis ◽

Abdominal Mass ◽

Relevant Literature ◽

Large Diameter ◽

Exploratory Laparotomy ◽

Clinical Findings ◽

Surgical Units ◽

Mechanical Intestinal Obstruction

The acute abdomen has many etiologies frequently encountered in emergency surgical units. Approximately 20% of surgical admissions for acute abdominal conditions are for intestinal obstruction. Clinicians often overlook rarer causes. A 43-year-old man presented to the emergency ward with the clinical findings of ileus. Computed tomography revealed a heterogeneous necrotic 168 × 100-mm mass between the sigmoid colon and urinary bladder. Physical examination revealed a palpable intra-abdominal mass that was removed via exploratory laparotomy. On histopathologic examination, the mass was identified as a seminoma. The literature contains few reports of seminoma as a cause of acute abdomen and ileus, mostly seen between the ages of 30 and 40 years. We report a patient with seminoma arising in an undescended testis that presented as a palpable painful lower abdominal mass and mechanical intestinal obstruction, despite the large diameter of the mass, as well as review relevant literature.

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Preliminary experience with Brown-Roberts-Wells (BRW) computerized tomography stereotaxic guidance system

Journal of Neurosurgery ◽

10.3171/jns.1983.59.2.0217 ◽

1983 ◽

Vol 59 (2) ◽

pp. 217-222 ◽

Cited By ~ 143

Author(s):

M. Peter Heilbrun ◽

Theodore S. Roberts ◽

Michael L. J. Apuzzo ◽

Trent H. Wells ◽

James K. Sabshin

Keyword(s):

Ct Scan ◽

Computerized Tomography ◽

Guidance System ◽

Production Model ◽

Ct Scanner ◽

Content Type ◽

Ct Scanners ◽

Guidance Systems ◽

Fine Print

✓ The production model of the Brown-Roberts-Wells (BRW) computerized tomography (CT) stereotaxic guidance system is described. Hardware and software modifications to the original prototype now allow the system to be used independently of the CT scanner after an initial scan with the localizing components fixed to the skull. The system is simple and efficient, can be used universally with all CT scanners, and includes a phantom simulator system for target verification. Preliminary experience with 74 patients at two institutions is described. It is concluded that CT stereotaxic guidance systems will become important tools in the neurosurgical armamentarium, as they allow accurate approach to any target identifiable on the CT scan.

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In memory of Georgiy Nicolaevich Tsibulyak

Vestnik of Russian military medical Academy ◽

10.17816/brmma62837 ◽

2020 ◽

Vol 22 (4) ◽

pp. 249-252

Author(s):

I. M. Samokhvalov ◽

V. I. Badalov ◽

N. A. Tiniankin ◽

P. P. Liashedko ◽

K. P. Golovko

Keyword(s):

Research Laboratory ◽

Traumatic Shock ◽

Gold Medal ◽

Clinical Findings ◽

Terminal State ◽

Surgical Trauma ◽

Senior Lecturer ◽

War Surgery ◽

Scientific Papers ◽

Surgery Department

The biography of colonel of Medical Corps, professor Georgiy Nicolaevich Tsibuliak (19322020) is presented. In 1956 G.N. Tsibuliak graduated from the Kirov Military Academy being awarded with gold medal. When being a cadet, he got actively engaged in research. In 1961 G.N. Tsibuliak defended candidates dissertation on the injury treatment in casualties damaged by ionizing radiation, took part in the study of multiple injuries occurring in atomic tests. After graduating from the medical residency he stayed in War Surgery department of the Academy, was eventually assigned as a senior lecturer, the head of the research laboratory carrying out the study of shock and terminal state. In1966 he defended a doctorate in pathogenesis, clinical findings and treatment of tetanus. G.N. Tsibuliak became one of the leading advocates for the concept of traumatic shock in individuals. This fact that at present emergency physicians and surgeons dealing with traumatic shock consider to be an axiom, is scientifically based, and was gained through hard routine work in treating severely injured casualties. From 1976 to 1982 Georgiy Nicolaevich was Surgeon-in-Chief in Group of Soviet Forces in Germany. In 19901993 he was in charge of research laboratory dealing with combat surgical trauma in the Academy. Since 1993 G.N. Tsibuliak had retired from active duty, holding the position of a professor at the War Surgery department. He is the author of more than 200 scientific papers, including 7 monographs. G.N. Tsibuliak was closest associate of A.N. Berkutov in studying traumatic shock in casualties, took an active part in formation of a new clinical specialty resuscitation.

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Association of socioeconomic and clinical variables with the state of frailty among older inpatients

Revista Latino-Americana de Enfermagem ◽

10.1590/0104-1169.0660.2657 ◽

2015 ◽

Vol 23 (6) ◽

pp. 1121-1129 ◽

Cited By ~ 1

Author(s):

Darlene Mara dos Santos Tavares ◽

Isabella Danielle Nader ◽

Mariana Mapelli de Paiva ◽

Flavia Aparecida Dias ◽

Maycon Sousa Pegorari

Keyword(s):

Older Adults ◽

Average Length ◽

The State ◽

Chi Square ◽

Frailty Phenotype ◽

Cross Sectional ◽

Average Length Of Stay ◽

Hospitalization Period ◽

Older Inpatients ◽

Materials Used

Objectives: to identify the prevalence of frailty among inpatient older adults in a clinical hospital and check the association of the socioeconomic and clinical characteristics with the state of frailty. Method: observational, cross-sectional and analytical study, conducted with 255 hospitalized patients. Materials used: structured instrument for the economical and clinical data and frailty phenotype of Fried. Descriptive and bivariate statistical analysis was carried out and, by means of chi-square tests and ANOVA One-way (p<0.05). Results: the prevalence of frailty corresponded to 26.3%, while pre-frailty represented 53.3%. The highest proportion of frail seniors was identified for 80 years or older (p = 0.004), widowed (p = 0.035) and with the highest average length of stay (p = 0.006). Conclusion: inpatient older adults presented high percentages of frail states associated with socioeconomic variables and hospitalization period. The identification of the health conditions related to pre-frailty and frailty can foster the planning and implementation of the assistance to older adults in this context.

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Analysis of Gastrointestinal Symptoms in 281 Cases of Hospitalized Covid 19 Patients, Single-Center Study

The Journal of Tepecik Education and Research Hospital ◽

10.5222/terh.2021.73603 ◽

2021 ◽

Author(s):

Gözde Derviş Hakim ◽

Şükran Köse ◽

Pınar Şamlıoğlu ◽

Cengiz Ceylan ◽

Mehmet Can Uğur ◽

...

Keyword(s):

Abdominal Pain ◽

Respiratory Symptoms ◽

Clinical Presentation ◽

Gastrointestinal Symptoms ◽

Clinical Analysis ◽

Clinical Findings ◽

Gastrointestinal System ◽

Detailed Review ◽

Single Center Study ◽

Gi Symptoms

Objective: Although Covid-19 which has been identified as the disease caused by SARS COV-2 virus mainly affects the respiratory tract, it was observed that many systems were affected. The gastrointestinal system is one of the main systems involved. The aim of this manuscript was to perform epidemiological, virological, and clinical analysis of 59 Covid 19-positive patients with gastrointestinal symptoms. Method: Covid-19 diagnosed patients have been started to be admitted since March, 20, 2020. Epidemiological, demographical, clinical findings, laboratory analyses as well as hospitalization periods and disease progression of the patients presenting gastrointestinal system (GIS) symptoms admitted between March, 31, 2020 and August, 1, 2020. Results: Totally 710 Covid 19-positive patients hospitalized were screened. Among these patients, those with incomplete medical history and deficient data were excluded. The analysis of 281 patients admitted due to Covid-19 diagnosis with complete data since admission revealed that 59 patients presented GIS symptoms at admission. The aforesaid patients were compared with 222 patients admitted due to Covid-19 without GIS symptoms within the same period. GIS symptoms were detected on 59 (59/281) (20.99%) patients admitted due to Covid-19. Detailed review of these patients revealed that 18 (18/59) (30.50%) patients had nausea-vomiting, 10 (10/59) (16.95%) patients had abdominal pain, and 31 (31/59) (52.55%) patients had GIS bleeding. It was observed that vomiting was added into the clinical presentation in 7 of 18 patients. Although there is not any diarrhea symptom alone, total number of cases with diarrhea+abdominal pain, diarrhea+nausea-vomiting, diarrhea+nausea-vomiting+abdominal pain was 17 (17/59) (28.81%) of 59 patients. Conclusion: According to the results of this study, we have found 20.99% gi symptoms in the hospitalizated patients due to Covid 19. Although GIS symptoms are not associated with disease severity, they are important for the identification and spread of the disease, along with respiratory symptoms.

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Magnesium Sulphate For Tetanus, review of two cases

Medicinus ◽

10.19166/med.v7i4.2386 ◽

2020 ◽

Vol 7 (4) ◽

pp. 112

Author(s):

Tirta Darmawan Susanto

Keyword(s):

Intensive Care ◽

Autonomic Dysfunction ◽

Magnesium Sulphate ◽

Case Series ◽

Clinical Findings ◽

Muscle Spasm ◽

World Health ◽

Control Muscle ◽

Hospitalization Period ◽

Health Organization

<div class="WordSection1">Introduction: Tetanus is critically ill disease with long term hospitalization period. It need to be carefully monitored, usually in intensive care unit and involves critical care physicians. Benzodiazepine is preferred by World Health Organization (WHO) for muscle spasm control in tetanus, but it will be less costly if magnesium sulphate can be used alone to control spasm and autonomic dysfunction in tetanus. We report a series of 2 tetanus cases that were treated using magnesium sulphate to provide a brief clinical description about the use of magnesium sulphate in tetanus. We also give a brief review on epidemiology, pathophysiology, clinical findings, diagnosis, and treatment of tetanus to provide implications for intensive care physicians. Methods : Case series reportResults : Two patients with tetanus was given magnesium sulphate infusion to control muscle spasm and autonomic dysfunction with good results as expected. Both of them were survive and discharged home in healthy condition.Conclusions :Magnesium sulphate can also be used to control muscle spasm and autonomic dysfunction although WHO recommend benzodiazepines for controlling muscle spasm. Intensive care physicians should have enough knowledge about tetanus and how it should be managed adequately to ensure survival from tetanus.</div>

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Attenuation imaging as a new ultrasonographic application for identifying placental haematoma

BMJ Case Reports ◽

10.1136/bcr-2020-239287 ◽

2021 ◽

Vol 14 (3) ◽

pp. e239287

Author(s):

Masahiro Yamaguchi ◽

Takeshi Umazume ◽

Kiwamu Noshiro ◽

Hidemichi Watari

Keyword(s):

Diagnostic Accuracy ◽

Placental Abruption ◽

Imaging Modality ◽

Clinical Findings ◽

Attenuation Imaging

We present a case in which attenuation imaging (ATI), a recently developed ultrasonographic application, facilitated the diagnosis of preplacental and postplacental haematoma. Placental abruption is a serious condition that affects the prognosis of infants and is difficult to diagnose. Ultrasonography is the primary imaging modality that complements the clinical findings in the diagnosis; however, its sensitivity is low, and improved diagnostic accuracy is desired. Here, we found that placental haematomas on the placental fetal surface observed at 19 weeks of gestation were indistinct from placental parenchyma in B-mode ultrasonographic imaging. In ATI, the placental parenchyma was colour-mapped, but the haematoma portion was not, which helped identify the haematoma. ATI, which also colour-maps uniform tissues, did not colour-map vessels within the placenta. ATI has a breakthrough potential for improving the diagnosis of placental abruption.

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The use of pre-operative computed tomography in the assessment of the acute abdomen

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221501663 ◽

2012 ◽

Vol 94 (2) ◽

pp. 102-107 ◽

Cited By ~ 10

Author(s):

J Weir-McCall ◽

A Shaw ◽

A Arya ◽

A Knight ◽

DC Howlett

Keyword(s):

Computed Tomography ◽

Diagnostic Accuracy ◽

General Hospital ◽

Acute Abdomen ◽

District General Hospital ◽

Operative Intervention ◽

Emergency Laparotomy ◽

Senior Consultant ◽

Original Report

INTRODUCTION While there are a lot of data on the accuracy of computed tomography (CT) in diagnosing specific causes of an acute abdomen, there is very little information on the accuracy of CT in the acute general surgical admissions workload. We look at the diagnostic accuracy of CT in patients presenting with an acute abdomen who ultimately required a laparotomy. METHODS Patients who underwent an emergency laparotomy between 2008 and 2010 at Eastbourne District General Hospital with pre-operative CT on the same admission were included in the study. The CT report was compared with the laparotomy and histology findings and, where a discrepancy existed, the original imaging was reviewed by a senior consultant blinded to the original report and laparotomy findings. RESULTS A total of 196 emergency laparotomies were performed over the 2–year period, with 112 patients undergoing pre-operative CT. Fifteen patients were excluded from the study due to missing notes. In the remaining 97 patients, 80 CT reports correlated with the final operative diagnosis, giving a diagnostic accuracy of 82%. Of these, the on-call registrar was the initial reporter in 37 scans, with a diagnostic accuracy of 78%. On review of the CT by a second consultant, this increased to 90 correlations, yielding an accuracy of 93%. Delay between CT and the operation did not significantly alter diagnostic accuracy, nor was there any statistically significant reduction in accuracy in reports issued by on-call registrars. CONCLUSIONS On first reporting, CT misses 18% of diagnoses that ultimately require operative intervention. Reducing the threshold for obtaining a second consultant radiologist review significantly improves the diagnostic accuracy to 93%.

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