Obstructed right Duari hernia

The caecum and appendix are uncommon contents of femoral hernia (Duari hernia). Diagnosis is usually intraoperative. We report a rare case of obstructed right femoral hernia in a 65-year-old woman. She was admitted into the accident and emergency department because of sudden irreducibility of a previously reducible right groin swelling of 5 years duration. She had obstructive symptoms with an irreducible right groin mass clinically diagnosed as obstructed right femoral hernia. A combination of infra-inguinal transverse incision and a lower midline laparotomy incision was used. The intraoperative findings included the herniation of the caecum and appendix into the right femoral canal. Patient had an uneventful recovery. Duari hernia is uncommon. A high index of suspicion and an experiencedsurgeon, who can handle uncommon findings should be involved in the management of obstructed femoral hernias.

Download Full-text

Transverse Skin Crease versus Vertical Midline Incision versus Laparoscopy for Right Hemicolectomy: A Systematic Review—Current Status of Right Hemicolectomy

BioMed Research International ◽

10.1155/2014/643685 ◽

2014 ◽

Vol 2014 ◽

pp. 1-16 ◽

Cited By ~ 3

Author(s):

Alberto Santoro ◽

Carlo Boselli ◽

Claudio Renzi ◽

Francesca Gubbiotti ◽

Veronica Grassi ◽

...

Keyword(s):

Operative Time ◽

Right Hemicolectomy ◽

Current Status ◽

Systematic Research ◽

Cochrane Central Register ◽

Midline Incision ◽

Transverse Incision ◽

Midline Laparotomy ◽

The Right ◽

Laparoscopic Hemicolectomy

Purpose. The right hemicolectomy may be conducted through laparoscopic or laparotomic surgery, transverse or midline incisions. The transverse laparotomy offers some advantages compared to the midline laparotomy and laparoscopy. A literature review was performed to evaluate the possible advantages of the transverse incision versus midline incision or laparoscopic right hemicolectomy.Methods. A systematic research was performed in Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, BioMed Central, and the Science Citation Index.Results. Laparotomic right hemicolectomy with transverse incision is preferable to laparotomic hemicolectomy with midline incision. A transverse incision offers a lessened postoperative pain following physical activity, a lessened need to administer analgesic therapy during the post-operative time, better aesthetic results, and a better post-operative pulmonary function. Open surgery with transverse or midline incision ensured a shorter operative time, lower costs and a greater length of the incision compared to the laparoscopic. However, there are no differences in the oncological outcomes.Conclusions. It was not possible to identify significant differences between the open right hemicolectomy with transverse incision versus the open right hemicolectomy with midline incision or laparoscopic hemicolectomy.

Download Full-text

Handedness and Hand Injuries

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(94)90154-6 ◽

1994 ◽

Vol 19 (2) ◽

pp. 158-161 ◽

Cited By ~ 16

Author(s):

A. A. BEATON ◽

L. WILLIAMS ◽

L. G. MOSELEY

Keyword(s):

Emergency Department ◽

Hand Injuries ◽

Medical Attention ◽

Male And Female ◽

Left Hand ◽

Female Patients ◽

Accident And Emergency ◽

Left And Right ◽

Accident And Emergency Department ◽

The Right

Data are reported from a study of 1,003 patients attending with hand injuries at an Accident and Emergency Department. Among both left- and right-handers, injuries to the right hand were more common than to the left hand, except for accidents to right-handers at work. For this group there were more injuries to the left hand. Male and female patients differ in the frequency with which they present for medical attention but show similar types of injury.

Download Full-text

INTESTINAL MALROTATION IN 35 YEAR OLD WOMEN FROM PESHAWAR, PAKISTAN

Gomal Journal of Medical Sciences ◽

10.46903/gjms/17.04.2097 ◽

2019 ◽

Vol 17 (4) ◽

pp. 145-149

Author(s):

Zubair Ahmad Khan ◽

Omer Nasim ◽

Zeinab Hussain ◽

Jamil Ahmad

Keyword(s):

Emergency Department ◽

Iliac Fossa ◽

Exploratory Laparotomy ◽

Acute Onset ◽

Midgut Volvulus ◽

Left Iliac Fossa ◽

Operative Care ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

The Right

Thirty five years old women presented to the Accident and Emergency Department with acute onset right upper quadrant abdominal pain with normal vitals. CT images revealed a malrotation causing midgut volvulus and intestinal obstruction. On emergency exploratory laparotomy, the gut loops showed partial ischemia due to a double twist at the root of mesentery and malrotation of the gut along with the caecum which was mobile coming from left iliac fossa and lying in the right iliac fossa. Duodeno-jejunal junction was identified. The coils of the intestine were untwisted and rotation was corrected. The gut color changed back to normal. She was discharged painless after routine post-operative care.

Download Full-text

Aortic Valve Fibroelastoma Masquerading as Transient Ischaemic Attack

Case Reports in Cardiology ◽

10.1155/2012/535783 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3

Author(s):

Penelope-Anne Gowland ◽

Ragheb Hasan

Keyword(s):

Emergency Department ◽

Chest Pain ◽

Aortic Valve ◽

Papillary Fibroelastoma ◽

Uneventful Recovery ◽

Shortness Of Breath ◽

Transient Ischemic Attacks ◽

Accident And Emergency ◽

Ischaemic Attack ◽

Accident And Emergency Department

The following paper is on a 49-year-old man who presented to accident and emergency department having experienced five hours of left-sided chest pain, tightness in the chest, and shortness of breath. He also reported paresthesia and an ache in the left arm. Further investigations revealed an aortic valve papillary fibroelastoma. Although histologically papillary fibroelastomas are described as benign, they carry with them considerable risk of morbidity and mortality. This patient experienced recurrent transient ischemic attacks (TIAs’). He was taken to theatre on urgent basis to remove the papillary fibroelastoma. His aortic valve was preserved during the operation. The patient had an uneventful recovery following the surgery. His neurologic symptoms resolved following the operation. The operation was curative and no further symptoms were reported at followup.

Download Full-text

An Unusual Complication of Cocaine Toxicity

Acute Medicine Journal ◽

10.52964/amja.0295 ◽

2013 ◽

Vol 12 (2) ◽

pp. 96-97

Author(s):

Lucy Houghton ◽

◽

Quentin Jones ◽

Chris Wathen ◽

◽

...

Keyword(s):

Uneventful Recovery ◽

Unusual Complication ◽

Blood Gas ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

Cocaine Toxicity ◽

Dark Blue ◽

Methaemoglobin Level

A 25-year man presented to the Accident and Emergency Department complaining of dizziness and shortness of breath after taking 70 grams of cocaine over 10 hours. He said a friend had noticed that his skin had turned dark blue. On examination the patient was severely centrally and peripherally cyanosed. His pulse oximeter oxygen saturations were 88% on air. An arterial blood gas showed a methaemoglobin level of 45.6%. The patient was diagnosed with cocaineinduced methaemoglobinaemia and given methyl thioninium chloride (methylene blue). He made an uneventful recovery.

Download Full-text

De Garengeot’s hernia in an elderly woman as a diagnostic challenge: a review of literature

BMJ Case Reports ◽

10.1136/bcr-2020-237526 ◽

2021 ◽

Vol 14 (1) ◽

pp. e237526

Author(s):

Zeeshan Saboor Ahmed ◽

Sufyan Azam ◽

Ayeshea Shenton ◽

Akinfemi Ayobami Akingboye

Keyword(s):

Femoral Hernia ◽

Elderly Woman ◽

Final Diagnosis ◽

Diagnostic Challenge ◽

Midline Laparotomy ◽

Hernia Sac ◽

Blind Ending ◽

History Of ◽

De Garengeot’S Hernia ◽

The Right

De Garengeot’s hernia is the presence of an appendix in a femoral hernia and can be a rare cause of an acute groin swelling. Here, we present a case report of an elderly woman who was referred to us with a short history of a painful, tender lump in the right groin associated with nausea and vomiting. Her inflammatory markers were raised, and to establish a final diagnosis, an urgent CT scan was requested which showed a blind ending tubular structure in a hernia sac. She was taken to the theatre for urgent exploration of the groin which revealed that it was a femoral hernia, the sac of which contained gangrenous appendix, the base of which could not be accessed through the groin incision and, therefore, a lower midline laparotomy incision was made and a formal appendicectomy was done.

Download Full-text

Prevalence and Distribution of Hand Fractures

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(03)00103-7 ◽

2003 ◽

Vol 28 (5) ◽

pp. 491-495 ◽

Cited By ~ 90

Author(s):

E. B. H. VAN ONSELEN ◽

R. B. KARIM ◽

J. JORIS HAGE ◽

M. J. P. F. RITT

Keyword(s):

Emergency Department ◽

Seasonal Variability ◽

Medical Centre ◽

Retrospective Survey ◽

Right Hand ◽

Hand Fractures ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

The Right ◽

Little Finger

A retrospective survey of the medical charts of all 36,518 patients attending the Accident and Emergency Department of the VU University Medical Centre, in Amsterdam, from January 1 to December 31, 1996 was performed. Of these, 4303 sustained one or more fractures, and hand fractures accounted for 19% of all fractures. Patients with hand fractures were typically men aged between 15 and 35 years. The right hand was involved as often as the left. Most of the hand fractures involved the metacarpals but, as a group of bones, the combined phalanges were most commonly fractured. The little finger ray was most commonly injured of the hand. We found no seasonal variability in the incidence of hand fractures.

Download Full-text

Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

The Surgery Journal ◽

10.1055/s-0041-1731443 ◽

2021 ◽

Vol 07 (03) ◽

pp. e124-e126

Author(s):

Mark Portelli ◽

Mark Bugeja ◽

Charles Cini

Keyword(s):

Computed Tomography ◽

Young Adult ◽

Rare Case ◽

Surgical Repair ◽

Bochdalek Hernia ◽

Case Presentation ◽

Atypical Case ◽

Accident And Emergency ◽

History Of ◽

Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

Download Full-text

The value of real-time ultrasound-guidance for definite placement of a right supraclavicular subclavian central venous catheter

The Journal of Vascular Access ◽

10.1177/1129729821998531 ◽

2021 ◽

pp. 112972982199853

Author(s):

Jens M Poth ◽

Stefan F Ehrentraut ◽

Se-Chan Kim

Keyword(s):

Ultrasound Guidance ◽

Venous Catheter ◽

Needle Insertion ◽

Major Surgery ◽

Axillary Vein ◽

Central Venous ◽

Supraclavicular Fossa ◽

The Right ◽

High Index Of Suspicion ◽

Insertion Process

Central venous catheters (CVC) are widely used in critically ill patients and in those undergoing major surgery. Significant adverse events, such as pneumothorax and hemothorax, can be caused by needle insertion during CVC insertion. CVC misplacement is less often described, yet equally important, as it can lead to deleterious complications. Here, we describe a case in which misplacement of a guidewire following infraclavicular puncture of the right axillary vein was detected by continuous ultrasound employing the right supraclavicular fossa view. Utilizing this ultrasound view, the insertion approach to the vessel was changed and correct CVC placement could be achieved. While ultrasound guidance is widely accepted for vessel puncture, this case demonstrates the value of continuous ultrasound guidance for the entire process of CVC insertion: vessel puncture, correct guidewire advancement, catheter placement, and exclusion of complications such as pneumothorax. It also shows that there should be a high index of suspicion for guidewire misplacement, even after successful venipuncture. In conclusion, ultrasound protocols covering the complete CVC insertion process should be implemented into current clinical practice.

Download Full-text