scholarly journals Abdominal Ultrasonography and Radiography Diagnosis in Preterm Necrotizing Enterocolitis

2016 ◽  
Vol 6 (2) ◽  
pp. 47-53
Author(s):  
S Tuya ◽  
Ch Battulga ◽  
TS Tsogtsolmaa ◽  
M Tumennasan ◽  
N Davaatseren ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Fluid Collection ◽  
Pneumatosis Intestinalis ◽  
Abdominal Ultrasound ◽  
Plain Radiography ◽  
Morbidity And Mortality ◽  
Free Fluid ◽  
Abdominal Ultrasonography ◽  
Group I ◽  
Free Air

Introduction: Necrotizing enterocolitis (NEC) is a major cause of neonatal morbidity and mortality. To explore whether abdominal ultrasound (AUS) provide additional information over plain radiography in cases of necrotizing enterocolitis (NEC).Materials & Methods: This study is a prospective study of 30 premature neonates with NEC in our neonatal intensive care unit between September 2013 and November 2014. Fifteen premature control neonates were also included in the study.Results: Patients were classified into two groups: the first group with suspected NEC (stage I) (n = 14) and the second with definite NEC (stage II or III) (n = 16). In group I abdominal ultrasound (AUS) revealed intramural air (n = 9) and portal venous gas (PVG) (n = 1) while plain radiography showed only gaseous distension. In group II, intramural air (n = 10), PVG (n = 2), free fluid (n = 6) focal fluid (n = 1) and free air (n = 6) detected by AUS compared to pneumatosis intestinalis (PI) (n = 2) PVG (n = 1) and free air (n = 5) by plain radiography. Additionally bowel wall thinning was detected in 2 neonates of group I and 3 of group II.Conclusion: Our results suggest AUS to be superior to plain radiography in early detection of complication as intestinal perforation by eliciting PVG and fluid collection and so early surgical management. Therefore this may decrease morbidity and mortality rates.J. Paediatr. Surg. Bangladesh 6(2): 47-53, 2015 (July)

Pleuroperitoneal true diaphragmatic hernia of the liver in a cat

2020 ◽  
Vol 48 (04) ◽  
pp. 292-296
Author(s):  
Mehmet Pilli ◽  
Fatma E. Özgencil ◽  
Deniz Seyrek-Intas ◽  
Cagri Gültekin ◽  
Kürsad Turgut
Keyword(s):  
Abdominal Ultrasound ◽  
Liver Parenchyma ◽  
Plain Radiography ◽  
Thoracic Cavity ◽  
Aminotransferase Activity ◽  
Liver Lobe ◽  
Abdominal Ultrasonography ◽  
Median Laparotomy ◽  
The Right ◽  
Alanine Aminotransferase Activity

AbstractA 2-year old female domestic shorthair cat was referred with intermittent vomiting. Laboratory analyses revealed only an elevated alanine aminotransferase activity. Plain thoracic radiographs showed a right-sided transdiaphragm protrusion of a liver lobe into the thoracic cavity. On abdominal ultrasound the diaphragm and liver parenchyma also presented a bulge towards the thoracic cavity. By cranial median laparotomy herniation of the quadrate liver lobe through the right aspect of the diaphragm into the thoracic cavity was confirmed. The protruding quadrate liver lobe was covered by intact parietal peritoneum. Following relocation of the liver lobe the defect was closed. Postoperatively the intermittent vomiting stopped. The purpose of this case report was to present plain radiography and abdominal ultrasonography as effective tools in the diagnosis of this rare and usually asymptomatic true herniation case along with its operative treatment.

scholarly journals A case of gastric leiomyosarcoma in a domestic shorthair cat

2018 ◽  
Vol 4 (2) ◽  
pp. 205511691881891
Author(s):  
Kirsty Hart ◽  
Harriet Brooks Brownlie ◽  
Daniel Ogden ◽  
Sabela Atencia
Keyword(s):  
Intestinal Tract ◽  
Gastric Wall ◽  
Abdominal Ultrasound ◽  
Free Fluid ◽  
Abdominal Ultrasonography ◽  
Complete Excision ◽  
Spindle Cell Proliferation ◽  
Gastric Lumen ◽  
Gastric Mass ◽  
Gastric Leiomyosarcoma

Case summary A 10-year-old male neutered domestic shorthair cat presented with nausea and 1.2 kg weight loss over a 6 month period. Physical examination was unremarkable, and haematological and biochemical results were considered clinically unremarkable. Abdominal ultrasound revealed an 18 mm diameter heterogeneous mass in the stomach at the pyloric sphincter, protruding into the gastric lumen with loss of gastric wall layering. The remainder of the intestinal tract and abdominal viscera were unremarkable and no free fluid was detected. The mass was surgically resected via celiotomy and the adjacent lymph node excised for histopathology. Histopathology of the mass demonstrated neoplastic spindle cell proliferation, which was considered most likely to be of smooth muscle origin, and so a preliminary diagnosis of gastric leiomyosarcoma was given. Complete excision was confirmed. Immunohistochemistry excluded a gastrointestinal stromal cell tumour as a differential and strongly supported the diagnosis of gastric leiomyosarcoma. The cat recovered well postoperatively with supportive treatment. Repeat abdominal ultrasonography 3 and 6 months postoperatively showed no evidence of mass regrowth. Survival time at the time of reporting is 10 months. Relevance and novel information To our knowledge, this is the first report of gastric leiomyosarcoma in a cat. Based on this case, gastric leiomyosarcoma should be a differential diagnosis for cats presenting with a gastric mass.

Complex Fluid Collection on Abdominal Ultrasound Indicates Need for Surgery in Neonates with Necrotizing Enterocolitis

2016 ◽  
Vol 27 (02) ◽  
pp. 161-165 ◽  
Author(s):  
Sylvie Kaiser ◽  
Tomas Wester ◽  
Henrik Arnell ◽  
Marco Bartocci ◽  
Elena Palleri
Keyword(s):  
Necrotizing Enterocolitis ◽  
Fluid Collection ◽  
Abdominal Ultrasound ◽  
Complex Fluid

scholarly journals Nonsurgical pneumoperitoneum detected using computed tomography: A retrospective study

2019 ◽  
Author(s):  
Wataru Adachi ◽  
Tomohito Matsushita ◽  
Yasuaki Yashiro ◽  
Jiro Imura ◽  
Hideki Shiozawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Bowel Wall ◽  
Fluid Collection ◽  
Laboratory Data ◽  
Pneumatosis Intestinalis ◽  
Maximum Diameter ◽  
Wall Thickening ◽  
Ct Findings ◽  
Free Air

Abstract Background Although several cases with pneumoperitoneum that does not require surgical intervention (nonsurgical pneumoperitoneum) have been reported, the characteristics of such cases remain unclear. The accurate diagnosis of nonsurgical pneumoperitoneum could minimize unnecessary surgery. The aim of this study was to clarify the clinical and radiological characteristics of cases with nonsurgical pneumoperitoneum detected using computed tomography. Methods This retrospective study was conducted at a single center. A total of 18513 abdominal computed tomography (CT) scans obtained between January 2010 and February 2017 were examined for pneumoperitoneum. Medical records of cases testing positive for extraluminal free air were analyzed. Results Extraluminal free air was detected in 254 examinations of 182 cases. Out of 88 examinations of 86 cases excluding iatrogenic air, colorectal perforation was the most common cause of extraluminal free air. Nonsurgical pneumoperitoneum was recognized in 25 examinations of 23 cases, and was the second most frequent. The frequency of nonsurgical pneumoperitoneum was 0.14% in all abdominal CT examinations. Most nonsurgical pneumoperitoneum cases did not exhibit severe general conditions, peritoneal signs, or leukocytosis. CT findings of bowel wall discontinuity, segmental bowel-wall thickening, perivisceral fat stranding, and abscess were not observed. Fluid collection was present in 8 of 23 cases, and the estimated volume of fluid collection was small. Pneumatosis intestinalis was simultaneously observed in 20 of 23 cases. No significant differences in the maximum diameter of intraperitoneal free air were observed between the grades of pneumatosis intestinalis (p=0.999). Follow-up CT examination, which was performed within 7 days after the detection of nonsurgical pneumoperitoneum, showed that the pneumatosis intestinalis and/or extraluminal free air often disappeared in a short time. Conclusions Nonsurgical pneumoperitoneum was common. The cause of extraluminal free air was pneumatosis intestinalis in most cases. Well-maintained general and local conditions and normal laboratory data were the clinical characteristics. The absence of CT findings indicative of peritonitis, little fluid collection, if any, and the presence of pneumatosis intestinalis were the radiological characteristics.

scholarly journals Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

2021 ◽  
Vol 23 (1) ◽  
pp. 33-49 ◽  
Author(s):  
Sally Griffin
Keyword(s):  
Adrenal Glands ◽  
Ultrasound Examination ◽  
Abdominal Ultrasound ◽  
Evidence Base ◽  
Vital Role ◽  
Abdominal Ultrasonography ◽  
Operator Experience ◽  
High Resolution Images ◽  
Clinically Significant ◽  
Diagnostic Work

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the adrenal glands can provide important information pertaining to several conditions including hyperaldosteronism and hyperadrenocorticism. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings, such as adrenal mineralisation, and clinically significant pathological changes can be challenging. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination of the normal and diseased adrenal glands. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. Equipment: Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

Early versus delayed operative management of appendicular mass

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hassan sayed Tantawy ◽  
Amr Mohamed El Hefny ◽  
Ahmed Yasser Abd El Halim ◽  
Mohammed Ali Abdel Ghaffar Nasr
Keyword(s):  
Retrospective Study ◽  
Acute Abdomen ◽  
Defense Mechanisms ◽  
Operative Management ◽  
University Hospital ◽  
Greater Omentum ◽  
Abdominal Ultrasonography ◽  
Military Hospitals ◽  
Group I ◽  
Appendicular Mass

Abstract Background Acute appendicitis is one of the most common causes of acute abdomen. It may be either complicated or uncomplicated. Sometimes the acute inflammation of the appendix may be enclosed by the patient’s own defense mechanisms to form inflammatory phlegmon. Complicated appendicitis is a palpable appendiceal mass, phlegmon, or a localized abscess. A phlegmon is an inflammatory tumor consisting of the inflamed appendix, with the greater omentum and adjacent viscera. Aim of the Work To determine the preferred approach taken to the management of the appendicular mass, to compare between acute appendectomy and delayed surgical intervention for appendicular mass, and to determine patient outcome following appendectomy for appendicular mass. Material and Methods: Study A retrospective study. Study Setting The study has been conducted in Ain Shams University Hospital (El-Demerdash) and military hospitals in Cairo and Alexandria under supervision of thesis supervisors. Study Period The study retrospectively analyze data of patients diagnosed as appendicular mass between January 2017 and December 2017. Study Population: Inclusion Criteria Patients with acute abdomen, diagnosed as appendicular mass by clinical examination and imaging (US and CT). Exclusion Criteria Females with right ovarian problems. Cases with right ureteric stones. Cases of recurrence. Abdominal ultrasonography and CT did not confirm the mass. Results The present study was a descriptive, retrospective, study that included 20 patients diagnosed with appendicular mass attended to surgery clinics at El-Demerdash and Military hospitals between January 2017 and December 2017. The patients were divided into two groups: Group I including 10 patients started conservative treatment then received delayed appendectomy. Group II including 10 patients received early appendectomy. Conclusion In conclusion, early appendicectomy is a safe and superior option in patients with appendicular mass compared to delayed appendicectomy. The results indicate that early appendicectomy leads to shorter hospital stay and return to normal activities than delayed appendicectomy. Moreover, postoperative difficulties and complications were less following early appendicectomy. The early appendectomy appears to achieve more favorable outcomes in patients with more severe symptoms, high fever, and high inflammatory markers. Nonetheless, more studies are necessary to confirm our findings.

scholarly journals Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emergency Physician ◽  
Gold Standard ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Free Fluid ◽  
Emergency Physicians ◽  
Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

scholarly journals Ruling out intra-abdominal injuries in blunt trauma patients using clinical criteria and abdominal ultrasound

2017 ◽  
Vol 44 (6) ◽  
pp. 626-632 ◽  
Author(s):  
Flávia Helena Barbosa Moura ◽  
José Gustavo Parreira ◽  
Thiara Mattos ◽  
Giovanna Zucchini Rondini ◽  
Cristiano Below ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Abdominal Ultrasound ◽  
Physical Exam ◽  
Trauma Patients ◽  
Abdominal Injuries ◽  
Hemodynamic Stability ◽  
Abdominal Ultrasonography ◽  
Clinical Criteria ◽  
Clinical Variables ◽  
Abdominal Lesions

ABSTRACT Objective: to identify victims of blunt abdominal trauma in which intra-abdominal injuries can be excluded by clinical criteria and by complete abdominal ultrasonography. Methods: retrospective analysis of victims of blunt trauma in which the following clinical variables were analyzed: hemodynamic stability, normal neurologic exam at admission, normal physical exam of the chest at admission, normal abdomen and pelvis physical exam at admission and absence of distracting lesions (Abbreviated Injury Scale >2 at skull, thorax and/or extremities). The ultrasound results were then studied in the group of patients with all clinical variables evaluated. Results: we studied 5536 victims of blunt trauma. Intra-abdominal lesions with AIS>1 were identified in 144 (2.6%); in patients with hemodynamic stability they were present in 86 (2%); in those with hemodynamic stability and normal neurological exam at admission in 50 (1.8%); in patients with hemodynamic stability and normal neurological and chest physical exam at admission, in 39 (1.5%); in those with hemodynamic stability, normal neurological, chest, abdominal and pelvic physical exam at admission, in 12 (0.5%); in patients with hemodynamic stability, normal neurological, chest, abdominal and pelvic physical exam at admission, and absence of distracting lesions, only two (0.1%) had intra-abdominal lesions. Among those with all clinical variables, 693 had normal total abdominal ultrasound, and, within this group, there were no identified intra-abdominal lesions. Conclusion: when all clinical criteria and total abdominal ultrasound are associated, it is possible to identify a group of victims of blunt trauma with low chance of significant intra-abdominal lesions.

scholarly journals Bacterial contamination of nasogastric feeding tube and development of neonatal sepsis in premature newborns: a prospective observational research at a tertiary care center in Gujarat, India

2018 ◽  
Vol 5 (4) ◽  
pp. 1462
Author(s):  
Rekha Thaddanee ◽  
Shamim Morbiwala ◽  
Hasmukh Chauhan ◽  
Jigar Gusani ◽  
Parima Dalal
Keyword(s):  
Necrotizing Enterocolitis ◽  
Neonatal Sepsis ◽  
Microbial Growth ◽  
Tertiary Care ◽  
Feeding Tube ◽  
Feeding Intolerance ◽  
Nasogastric Feeding ◽  
Premature Newborns ◽  
Nasogastric Feeding Tube ◽  
Group I

Background: The objective of the present study is to observe the effect of frequency of changing nasogastric feeding tube (NG-FT) on microbial growth in relation to development of neonatal sepsis in premature newborns. The study is prospective observational study in its nature. Neonatal intensive care unit (NICU) of a tertiary care teaching hospital of western Gujarat, India, from December 2016 to November 2017.Methods: Eighty-five preterm newborns admitted to NICU for feeding support were randomly divided into three groups depending on frequency of changing nasogastric feeding tubes (Group I, II and III with NG-FT changed every 12, 24 and 48 hourly respectively). In Groups I, II and III, the first NG-FT cultures were sent at the end of 12, 24, 48 hours of NG-FT insertion respectively. The second and third NG-FT cultures were sent after 7 and 14 days respectively. Microbial growth pattern was observed and correlated with development of necrotizing enterocolitis (NEC), neonatal sepsis and mortality.Results: Microbial growth on first NG-FT culture significantly increased when frequency of changing nasogastric feeding tube was reduced from every 12 to 24 or 48 hours {p = 0.0432 (Group I vs II) and 0.0001 (Group I vs III)}. Microbial growth increased on second (24.1%, 87% and 85% in groups I, II and III respectively) and third NG-FT culture (44% in group I and 100% in groups II and III); this was significantly high in group II and III as compared to group I (p = 0.0001). Common organisms isolated were Klebsiella pneumonia (63.28%), Pseudomonas aeruginosa (32%) and Escherichia coli (21%). No significant difference was noted in incidences of feeding intolerance, necrotizing enterocolitis (NEC), neonatal sepsis and mortality among the three groups.Conclusions: Organism growth in nasogastric feeding tube culture increases significantly when frequency of changing NG-FT is beyond 12 hours. However, there is no increase in episodes of feeding intolerance, necrotizing enterocolitis (NEC), neonatal sepsis and mortality.

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