A Rare Case of Gastric Volvulus with Hiatal Hernia

​BY FAHAD SHAH &AHMED RAZIUDDIN, MDA 68-year-old woman presented with acute abdominal pain that had started three hours earlier. She said she had constant upper abdominal pain that was sharp and stabbing, and she rated her pain as 8/10.The patient said the pain did not radiate, and she was clearly in acute distress. She reported that her last meal had been four hours before and that she was nauseated and had had three to four episodes of dry heaves.She had no other concerning symptoms, and her pain was unaffected by eating, drinking, or position. She had a paraesophageal rolling hiatal hernia and was aware of her chronic condition, but had not sought treatment because it was not overtly symptomatic besides mild GERD and indigestion.She had a blood pressure of 156/100 mm Hg, a pulse of 70 bpm, a respiratory rate of 20 bpm, and an oxygen saturation of 97% on room air. Her pain was above the umbilical region, and she was in a left lateral decubitus position to cope with the pain. The examination revealed upper abdominal tenderness, minimal distention, and normal bowel sounds without guarding or rebound tenderness.She was given ondansetron 4 mg, morphine 4 mg, and IV fluids. The patient's blood panel showed a low RBC count of 4.15 m/uL, a hemoglobin of 11.7 g/dL, and a slightly decreased hematocrit of 36.4%. Her neutrophils were high at 82.5%, lymphocytes were low at 14.5%, and glucose was elevated at 162 mg/dL. Her lactic acid and lipase were elevated at 2.4 mmol/L and 127...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

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Publication date: 20 September 2019Source: Journal of Molecular Biology, Volume 431, Issue 20Author(s): Ludovic SauguetAbstractDNA and RNA polymerases (DNAP and RNAP) play central roles in genome replication, maintenance and repair, as well as in the expression of genes through their transcription. Multisubunit RNAPs carry out transcription and are represented, without exception, in all cellular life forms as well as in nucleo-cytoplasmic DNA viruses. Since their discovery, multisubunit RNAPs have been the focus of intense structural and functional studies revealing that they all share a well-conserved active-site region c...
Source: Journal of Molecular Biology - Category: Molecular Biology Source Type: research
Authors: Van Slambrouck J, Vlasselaers J, Devos B Abstract Peritoneal tuberculosis is a rare extrapulmonary manifestation of tuberculosis. Considering the diagnosis of peritoneal tuberculosis in a low prevalence setting can be vital for the further clinical management in selected patients.In a young male with migration background, presenting with generalised abdominal pain, computed tomography revealed ascites, omental and peritoneal thickening and enlarged mesentery lymph nodes. Computed tomography also revealed a distal ureteral calculus at the right vesico-ureteral junction. Diagnostic laparoscopy showed a nodul...
Source: Acta Chirurgica Belgica - Category: Surgery Tags: Acta Chir Belg Source Type: research
This study aimed to analyze the early and mid-term outcomes of aortic valve replacement with bovine pericardium in the treatment of aortic valve regurgitation.From January 2015 to March 2018, 36 patients (19 men; mean ± standard deviation [SD] age, 46.70 ± 16.60 years) underwent aortic valve replacement with bovine pericardium. The bovine pericardium was intraoperatively measured and shaped using an Ozaki template, according to the shape and size of the individual patient's aortic valve leaflets. Additional procedures were performed, including ventricular septal defect repair in 5 cases, mitral valve reconstr...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Publication date: Available online 18 November 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Hongwei Liu, Junfeng Liu, Xianfeng Xie, Xuebin LiAbstractThough anesthetic drug delivery system and drug vehicles is generally applied for pain relief, there are have many difficulties and issues due to its short duration carrier and low biocompatibility, effectiveness at the conditions of inflammation at acidic pH. To resolve this issue, we have designed and developed the dual (pH and temperature) responsive bio-nanomaterial to improve the efficiency anesthetic drug delivery system. Chitosan is a uniq...
Source: Journal of Photochemistry and Photobiology B: Biology - Category: Speech-Language Pathology Source Type: research
BACKGROUND: Prognosis of musculoskeletal disorders following injury is essential in determining appropriate treatment and care. A generic validated prognostic tool to stratify risk of poor recovery for people with musculoskeletal injuries after road traffi...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Research Methods, Surveillance and Codes, Models Source Type: news
Journal of Laparoendoscopic&Advanced Surgical Techniques, Ahead of Print.
Source: Journal of Laparoendoscopic and Advanced Surgical Techniques - Category: Surgery Authors: Source Type: research
We describe a method by using combined wedge non-VBG to correct the nonunion deformity when treating scaphoid nonunion with pedicled VBG. The wedge bone graft was harvested just proximal to the 2,3 intercompartmental supraretinacular artery VBG and was used as an inlay at the volar site to correct the humpback deformity, whereas the VBG was set at the dorsal site for bone bridging and blood supply. We also present our results of 10 patients with scaphoid fracture nonunion and humpback deformity treated with this method. Bone healing was achieved and the lateral intrascaphoid angles could be improved in all the 10 patients....
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Techniques Source Type: research
Disruption to the flexor pulley system of the thumb is an infrequent but devastating injury that can lead to significant compromise in both strength and function. Acute rupture leads to pain, weakness, reduced range of motion (ROM), and potential bowstringing of the flexor tendons. Conservative treatment with a pulley ring should be considered in all patients. However, failure of conservative treatment and bowstringing of the thumb are indications for operative intervention. Reconstruction of the oblique pulley system can be performed either in situ or using a free palmaris longus graft. Care should be taken to identify th...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Techniques Source Type: research
We describe a technique to improve visualization and isolation of Dupuytren cords using a tongue depressor.
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Techniques Source Type: research
Journal of Laparoendoscopic&Advanced Surgical Techniques, Ahead of Print.
Source: Journal of Laparoendoscopic - Category: Surgery Authors: Source Type: research
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