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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CONCLUSIONS: EUS-guided cyst ablation of pancreatic cystic lesions seems effective and safe as an alternative to surgical resection in patients who are unfit for surgery or who have low-risk pancreatic cystic neoplasms. PMID: 32741440 [PubMed - in process]
Source: Danish Medical Journal - Category: General Medicine Tags: Dan Med J Source Type: research
CONCLUSIONS: Supervised progressive resistance training might be of clinical relevance for patients with hip osteoarthritis and was effective in improving patient-reported function, hip-related pain and health-related quality of life. The level of evidence is low and future studies may therefore affect the findings reported herein. PMID: 32741435 [PubMed - in process]
Source: Danish Medical Journal - Category: General Medicine Tags: Dan Med J Source Type: research
CONCLUSIONS: Polypharmacy is prevalent in Denmark with no relevant regional differences. The prevalence of polypharmacy increased with age, and more than half of the population aged ≥ 75 years redeemed prescriptions for> 5 different medicines. The most redeemed medicines among older citizens were against pain and cardiovascular disease. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 32741431 [PubMed - in process]
Source: Danish Medical Journal - Category: General Medicine Tags: Dan Med J Source Type: research
Publication date: Available online 3 August 2020Source: The Annals of Thoracic SurgeryAuthor(s): Shintaro Katahira, Yukiharu Sugimura, Payam Akhyari, Artur Lichtenberg
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Mustard procedure – Cardiology MCQ Mustard procedure is:  Atrial based repair of d-TGA using an intra atrial baffle Repair for tricuspid atresia Arterial switch operation for d-TGA Double switch operation for corrected TGA Post your answer as a comment below. Correct answer will be posted after 2 days. The post Mustard procedure – Cardiology MCQ appeared first on All About Cardiovascular System and Disorders.
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
In this study of cancer patients receiving strong opioids, acetaminophen use was not associated with improved pain control or reduced opioid utilization, but was associated with a greater LOS. PMID: 32744914 [PubMed - as supplied by publisher]
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
In conclusion, HA20 should be considered in the differential diagnosis of an infant with an early-onset dominantly inherited inflammatory disease that presents with recurrent oral and genital ulcerations and fluctuating autoantibodies. Additionally, it also should be considered in an infant with suspected NLE, whose symptoms and abnormal autoantibodies persist. PMID: 32743991 [PubMed - in process]
Source: Journal of Korean Medical Science - Category: Biomedical Science Tags: J Korean Med Sci Source Type: research
Women approximate one-third of the annual 2.8 million people in the United States who sustain traumatic brain injury (TBI). Several clinical reports support or refute that menstrual cycle-dependent fluctuations in sex hormones are associated with severity of persisting post-TBI symptoms. Previously, we reported late-onset sensory hypersensitivity to whisker stimulation that corresponded with changes in glutamate neurotransmission at 1-month following diffuse TBI in male rats. Here, we incorporated intact age-matched naturally cycling females into the experimental design while monitoring daily estrous cycle. We hypothesized...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
AbstractComplex regional pain syndrome (CRPS) is a regional, neuropathic  pain disorder, with disproportionate symptoms, that does not respect dermatomes or nerve distribution. A 28-year-old female patient with personal history of two breast augmentation surgeries consulted for breast reduction after dissatisfaction with the size and form of her breasts. Breast reductio n was undertaken with prosthesis exchange. During the first 10 days, she presented swelling, hyperesthesia, and burning pain mainly around her left breast. An ultrasound showed seroma collection which was drained in two occasions. She wa...
Source: European Journal of Plastic Surgery - Category: Cosmetic Surgery Source Type: research
We report a case of a 53-year-old patient who underwent three consecutive bilateral autologous breast reconstructions due to serial flap failure. Donor site morbidity after bilateral transverse myocutaneous gracilis (TMG), superior gluteal artery perforator (SGAP) and deep inferior epigastric perforator (DIEP) flap harvest was evaluated by the patient according to different variables. While the three donor sites were graded differently regarding postoperative pain, wound healing and aesthetics, no functional deficit was reported. Taking into account all variables, the DIEP donor site was rated most favourably and the TMG d...
Source: European Journal of Plastic Surgery - Category: Cosmetic Surgery Source Type: research
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