Laparoscopic management of acute abdominal emergencies
Publication date: Available online 12 September 2019Source: Surgery (Oxford)Author(s): Rishabh Singh, Andrea ScalaAbstractUse of minimally invasive approaches to acute abdominal surgical emergencies has increased in recent decades. Uptake has been slower than for elective surgery, however, with concerns regarding inadvertent injury and operative time being most frequently cited. Laparoscopy for abdominal pain has shown to be safe and is a useful diagnostic procedure in the context of unexplained abdominal pain. Minimally invasive surgery has also been shown to be the approach of choice in appendicitis and cholecystitis. Laparoscopy has shown to be useful in trauma patients and may obviate the need for laparotomy. Management of perforated peptic ulcers has shown to be feasible and safe, with some uncertainty as to the superiority over an open approach. The management of perforated diverticulitis has been the subject of much debate, with significant risk possibly associated with minimally invasive lavage. Small bowel obstruction may also be managed using laparoscopy but the potential for inadvertent injury remains. While useful and certainly yielding benefits in terms of postoperative recovery when performed without incident, the decision to proceed minimally invasively in many acute abdominal emergencies must be taken by clinicians and surgical teams with suitable experience and expertise.
It's been my sense that this specialty is counter-cyclical in nature. If the economy tanks and more people are out of work, filing comp &disability claims, will this be good for the specialty?
The objective of this study was to evaluate the impact of digital ulcers (DUs) in daily life of systemic sclerosis (SSc) Spanish patients. We developed a multicenter observational study to compare functional disability in SSc patients with active DUs vs. those without DUs. An additional correlation between perception of patients and physicians on disability due to DUs was performed. A total of 199 patients were enrolled, 70 (35%) with DUs. Patients with DUs were younger (48 vs. 58 years;p
This study aims to validate this observation. Blood levels of seven cytokines were measured in 120 patients with pSS from the United Kingdom Primary Sjögren’s Syndrome Registry and 30 age-matched healthy non-fatigued controls. Patient-reported scores for fatigue were classified acco rding to severity and compared to cytokine levels using analysis of variance. The differences between cytokines in cases and controls were evaluated using Wilcoxon test. A logistic regression model was used to determine the most important identifiers of fatigue. Five cytokines, interferon-γ-induced protein-10 (IP-10), tumour ne...
Honestly, I typically wait atleast a 8months or 1 year before doing a SCS trial and usually after 1-2 ESIs didnt help. But I'm wondering if I'm too conservative.... Surgeons do their surgeries and usually tell patients, "it may take 6months to 1 year" to fuse. They tell their patients that we arent necessarily doing the surgery for pain, but to "stabilize" the spine. I was recently told that in theory if after 3months and there's no fusion or pseudoarthrosis, then one should consider... when after fusion/laminectomy do yo consider SCS therapy?
Publication date: Available online 14 October 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Christine E. Foley, Erin Rhinehart, Noah Rindos
The unnamed woman from Vietnam woke up in sudden pain. At hospital, a doctor discovered a large cockroach stuck inside the canal which took a couple of minutes to remove.
The University of California, San Francisco (UCSF) is launching a new center...Read more on AuntMinnie.comRelated Reading: Radiofrequency ultrasound, AI predict thyroid cancer AI model could speed up pneumonia diagnosis in ED Societies team up to promote ethics in radiology AI AI algorithm can accurately diagnose appendicitis Nvidia, ACR collaborate on AI for radiology
ConclusionsExtra-pelvic endometriosis, traditionally thought to be rare, have been reported in a considerable number of cases. Heightened awareness and clinical suspicion of the disease, and multi-disciplinary approach is recommended to achieve prompt diagnosis and optimize patient outcomes. At this time, there are no comparative studies to provide recommendations regarding optimal diagnostic methods, treatment options and outcomes for endometriosis involving extra-pelvic sites.
BY ALEJANDRO E. MACIAS; BILLY ZHANG; KRISTEN HUGHES; SHAMIM KHAN, MD; FRANCISCO JACOME, MDA 73-year-old man with a past medical history of hypertension, type 2 diabetes, and hyperlipidemia and a surgical history for a coronary artery bypass presented with sudden, severe lower abdominal pain. He characterized his pain as 8/10 and was tender to palpation.Laboratory studies showed a white blood cell count of 7.51 with a glucose of 759, no bands, a platelet count of 230,000, and a lactic acid level of 6.7. Urinalysis showed +5 ketones and a glucose count of greater than 500. An abdominal CT showed possible microperforations...
Abstract The greatest advantages of laparoscopy when compared to open surgery include the faster recovery times, shorter hospital stays, decreased postoperative pain, earlier return to work and resumption of normal daily activity as well as cosmetic benefits. Laparoscopy today is considered the gold standard of care in the treatment of cholecystitis and appendicitis worldwide. Laparoscopy has even been adopted in colorectal surgery with good results. The technological improvements in this surgical field along with the development of modern techniques and the acquisition of specific laparoscopic skills have allowed...