This patient experienced persistent vomiting and inability to swallow after accidentally ingesting sulfuric acid. He was diagnosed with an esophageal stricture and diverticulum via endoscopy. The stricture was initially dilated but he remained unable to eat solid foods. Further endoscopy revealed the diverticulum, and radiological studies showed spillage into the trachea and strictures in the stomach and duodenum from the acid exposure. The patient has been diagnosed with an esophageal stricture and diverticulum resulting from the ingestion of sulfuric acid.
In these slides we will go through the surgical anatomy of the gut,pathophysiology of intestinal obstruction, clinical presentation and management. Also we will discuss specific types of intestinal obstruction.
1) The document discusses motility disorders of the esophagus, including achalasia, diffuse esophageal spasm, nutcracker esophagus, and ineffective esophageal motility.
2) It provides details on the anatomy, physiology and functions of the esophagus, as well as the classification, symptoms, investigations and treatments of various esophageal motility disorders.
3) Achalasia is characterized by failure of the lower esophageal sphincter to relax during swallowing, leading to symptoms like dysphagia and regurgitation. It is diagnosed using barium swallow, chest X-ray and manometry. Treatment involves botox injections or surgical myotomy.
The spleen is normally located in the left upper quadrant of the abdomen. This case presents a 20-year-old female with abdominal pain who was found to have a torsed wandering spleen at the center of her abdomen. Wandering spleen is a condition where the spleen lacks normal ligamentous support, causing it to be mobile within the abdomen. At surgery, her enlarged spleen was found to have torsed along its vascular pedicle, cutting off its blood supply. A splenectomy was performed to remove the non-viable spleen. Histopathology confirmed splenic infarction due to the torsion.
This document provides an overview of the esophagus, including its anatomy, physiology, common diseases, and diagnostic testing. Key points include:
- The esophagus connects the pharynx to the stomach and propels food through peristaltic contractions. It has three sections - cervical, thoracic, abdominal.
- Gastroesophageal reflux disease is common, caused by backflow of gastric acid into the esophagus. Risk factors include obesity, smoking, diet.
- Esophageal tears can range from superficial mucosal tears to full perforations, which require urgent treatment due to risk of mediastinitis and sepsis.
- Diagnostic tests include barium swallow,
Central abdominal pain and masses can have many potential causes. A thorough history and physical exam are important to narrow the differential diagnosis, which may include appendicitis, small bowel obstruction, or mesenteric ischemia. Imaging studies like CT scans can help identify potential causes like bowel obstructions or masses. Treatment depends on the underlying condition but may involve resuscitation, surgery, or conservative management in cases of small bowel obstruction. The key is making an accurate diagnosis to guide appropriate treatment.
This document outlines a presentation on the pathophysiology and management of acute abdomen. It begins with definitions of acute abdomen and types of abdominal pain. Pathophysiological mechanisms including luminal obstruction, inflammation, peritonitis, ischemia and non-specific pain are described. Common causes like appendicitis, cholecystitis, bowel obstruction and perforated viscus are listed. Immediately life-threatening diagnoses of perforated viscus, bowel ischemia, ruptured abdominal aortic aneurysm and ruptured ectopic pregnancy are highlighted. Clinical assessment techniques and investigations are outlined. Management principles focusing on ABCs, fluid resuscitation and need for surgery in some cases are emphasized in the take-home message.
The document provides information on various causes of dysphagia (difficulty swallowing). It discusses reflux esophagitis, the most common cause, describing symptoms like heartburn relieved by antacids. It also covers benign esophageal stricture, usually due to reflux, presenting with slowly progressive dysphagia. Achalasia is described as lack of LES relaxation, causing longstanding dysphagia and vomiting of stale food. Treatment options like pneumatic dilation are mentioned. Finally, it provides a clinical scenario of a patient with symptoms suggestive of reflux esophagitis.
Tasleem Akhtar, a 50-year old female, presented with post-prandial vomiting, abdominal pain, and constipation. Imaging showed signs of intestinal obstruction. She underwent exploratory laparotomy, which found a stricture in the sigmoid colon due to a hard mass. A segment of the sigmoid colon was resected along with the mass. Histopathology revealed colorectal cancer. She was diagnosed with colorectal cancer affecting the sigmoid colon.
In these slides we will go through the surgical anatomy of the gut,pathophysiology of intestinal obstruction, clinical presentation and management. Also we will discuss specific types of intestinal obstruction.
1) The document discusses motility disorders of the esophagus, including achalasia, diffuse esophageal spasm, nutcracker esophagus, and ineffective esophageal motility.
2) It provides details on the anatomy, physiology and functions of the esophagus, as well as the classification, symptoms, investigations and treatments of various esophageal motility disorders.
3) Achalasia is characterized by failure of the lower esophageal sphincter to relax during swallowing, leading to symptoms like dysphagia and regurgitation. It is diagnosed using barium swallow, chest X-ray and manometry. Treatment involves botox injections or surgical myotomy.
The spleen is normally located in the left upper quadrant of the abdomen. This case presents a 20-year-old female with abdominal pain who was found to have a torsed wandering spleen at the center of her abdomen. Wandering spleen is a condition where the spleen lacks normal ligamentous support, causing it to be mobile within the abdomen. At surgery, her enlarged spleen was found to have torsed along its vascular pedicle, cutting off its blood supply. A splenectomy was performed to remove the non-viable spleen. Histopathology confirmed splenic infarction due to the torsion.
This document provides an overview of the esophagus, including its anatomy, physiology, common diseases, and diagnostic testing. Key points include:
- The esophagus connects the pharynx to the stomach and propels food through peristaltic contractions. It has three sections - cervical, thoracic, abdominal.
- Gastroesophageal reflux disease is common, caused by backflow of gastric acid into the esophagus. Risk factors include obesity, smoking, diet.
- Esophageal tears can range from superficial mucosal tears to full perforations, which require urgent treatment due to risk of mediastinitis and sepsis.
- Diagnostic tests include barium swallow,
Central abdominal pain and masses can have many potential causes. A thorough history and physical exam are important to narrow the differential diagnosis, which may include appendicitis, small bowel obstruction, or mesenteric ischemia. Imaging studies like CT scans can help identify potential causes like bowel obstructions or masses. Treatment depends on the underlying condition but may involve resuscitation, surgery, or conservative management in cases of small bowel obstruction. The key is making an accurate diagnosis to guide appropriate treatment.
This document outlines a presentation on the pathophysiology and management of acute abdomen. It begins with definitions of acute abdomen and types of abdominal pain. Pathophysiological mechanisms including luminal obstruction, inflammation, peritonitis, ischemia and non-specific pain are described. Common causes like appendicitis, cholecystitis, bowel obstruction and perforated viscus are listed. Immediately life-threatening diagnoses of perforated viscus, bowel ischemia, ruptured abdominal aortic aneurysm and ruptured ectopic pregnancy are highlighted. Clinical assessment techniques and investigations are outlined. Management principles focusing on ABCs, fluid resuscitation and need for surgery in some cases are emphasized in the take-home message.
The document provides information on various causes of dysphagia (difficulty swallowing). It discusses reflux esophagitis, the most common cause, describing symptoms like heartburn relieved by antacids. It also covers benign esophageal stricture, usually due to reflux, presenting with slowly progressive dysphagia. Achalasia is described as lack of LES relaxation, causing longstanding dysphagia and vomiting of stale food. Treatment options like pneumatic dilation are mentioned. Finally, it provides a clinical scenario of a patient with symptoms suggestive of reflux esophagitis.
Tasleem Akhtar, a 50-year old female, presented with post-prandial vomiting, abdominal pain, and constipation. Imaging showed signs of intestinal obstruction. She underwent exploratory laparotomy, which found a stricture in the sigmoid colon due to a hard mass. A segment of the sigmoid colon was resected along with the mass. Histopathology revealed colorectal cancer. She was diagnosed with colorectal cancer affecting the sigmoid colon.
1) Gastroesophageal reflux disease (GERD) occurs when gastric contents reflux into the esophagus in excessive amounts, causing symptoms or mucosal injury.
2) Common symptoms include heartburn and regurgitation. Complications include esophagitis, strictures, and Barrett's esophagus.
3) Diagnosis is usually made clinically based on symptoms. Testing with endoscopy, pH monitoring, or impedance monitoring may be used to confirm diagnosis or assess for complications.
4) Treatment involves lifestyle modifications and medication like antacids, H2 blockers, or proton pump inhibitors. Reflux surgery may be considered for severe cases.
The document discusses the anatomy and physiology of the esophagus. It describes the esophagus as a muscular tube that extends from the pharynx to the stomach. It has three portions - cervical, thoracic, and abdominal. The document outlines the relations of the esophagus in each portion and describes conditions like dysphagia, esophageal sphincters, gastroesophageal reflux disease, achalasia, Zenker's diverticulum and their clinical features and treatments.
This document discusses various motility disorders and conditions that affect the esophagus. It begins by describing different types of motility disorders like achalasia and diverticula. It then focuses on achalasia, describing its pathogenesis, clinical presentation, diagnostic tests like esophagram and manometry, and various treatment methods. The document also discusses other topics like esophageal diverticula, benign and malignant neoplasms, perforations, injuries, and acid reflux conditions like Barrett's esophagus. Esophageal manometry is described as the most accurate way to assess motility disorders, and high-resolution manometry is mentioned as an improved technique.
A 59-year-old Chinese man was admitted to the hospital for vomiting blood. He has a history of hepatitis C and is a smoker, drinker, and former drug user. Physical examination found abdominal distension with fluid thrill and shifting dullness. Testing showed signs of liver dysfunction. The provisional diagnosis is esophageal varices secondary to liver disease, likely cirrhosis. Esophageal varices form as a result of portal hypertension in liver disease and can bleed, potentially severely. Treatment focuses on stopping the bleeding and lowering portal pressure through various medical and procedural options.
Intestinal obstruction presentation (Larg & Small Bowel Obstruction).pptxKhansamohamed2
This document discusses intestinal obstruction, including its causes, types, clinical features and management. There are two main types - mechanical (dynamic) obstruction which is due to a physical blockage, and adynamic obstruction which is failure of peristalsis without a blockage. Clinical features include abdominal pain, vomiting, distension and constipation. Management involves relieving the obstruction, resuscitation and treating any underlying cause. Surgery may be needed for cases of strangulation or if conservative measures fail.
DYSPHAGIA By JUSTUS and FLORENCE.pptx vbbwilgusbaraza1
Dysphagia is difficulty swallowing that can involve solids or liquids. It has many potential causes like GERD, esophageal cancer, foreign bodies, corrosive injuries, and neurological disorders. Evaluation involves history, exam, imaging like barium swallow and endoscopy. Management focuses on lifestyle changes, nutrition support, medications, dilation, stenting, radiation/surgery depending on the underlying cause. Complications can include pneumonia, malnutrition, and weight loss if left untreated.
1) Acute intestinal obstruction occurs when intestinal contents cannot move through the bowel lumen. It is most commonly caused by adhesions in the small intestine.
2) Symptoms include abdominal pain, distention, vomiting, and absence of bowel sounds or gas/stool. This leads to fluid and electrolyte imbalances if not treated.
3) Treatment involves NG decompression, IV fluids, and sometimes surgery to remove the obstruction or resect nonviable bowel segments. Nursing care focuses on pain management, prevention of dehydration and complications.
This document discusses non-malignant causes of dysphagia. It begins with anatomy of the oropharynx and esophagus, followed by causes of oropharyngeal and esophageal dysphagia including neurological, muscular, motility and structural issues. Specific motility disorders like achalasia, diffuse esophageal spasm and ineffective esophageal motility are explained. Other esophageal pathologies discussed include strictures, rings, webs, gastroesophageal reflux disease, Barrett's esophagus, diverticula and infectious esophagitis. Investigations and management of various conditions causing non-malignant dysphagia are summarized.
This document presents a case report of a 55-year-old male patient presenting with an indirect inguinal hernia on the right side that had become incarcerated. The patient reported a 2 year history of a reducible inguinal mass that had recently become painful and irreducible. On examination, an irreducible inguinal-scrotal mass was found. The patient underwent hernioplasty with mesh to repair the indirect inguinal hernia. Post-operatively, the patient was discharged with antibiotics and pain medications. The document reviews the clinical presentation, workup, surgical repair, and post-operative care of the patient.
The oesophagus is a 25cm tube connecting the pharynx to the stomach. It has three normal constrictions and consists of four layers. The main muscle layer contains striated muscle in the upper third and smooth muscle in the lower third. Achalasia cardia is failure of the lower oesophageal sphincter to relax during swallowing. Carcinoma of the oesophagus is often caused by smoking and alcohol and spreads locally and via lymph nodes or blood. Barium swallow and endoscopy are used to diagnose it. Treatment depends on the location but may include surgery, radiation, chemotherapy or palliation.
Gallbladder and biliary tract disorders are common, affecting around 20 million people in the US each year. The most common conditions are gallstones and cholecystitis. Gallstones form when bile contains too much cholesterol, bilirubin, or calcium salts. Cholecystitis is inflammation of the gallbladder which can be acute or chronic. Surgical removal of the gallbladder (cholecystectomy) is often required to treat symptomatic gallbladder disease or prevent complications like infection or gallstone obstruction. Nursing care focuses on managing pain, monitoring for complications, and educating patients on signs of issues after surgery.
CHRONIC LIVER DISEASE, CLD, is characterized by chronic abnormal functioning of liver due to various causes including hepatitis, alcoholic liver disease, non-alcoholic liver disease, autoimmune and certain medications.
visit https://surgio.info/chronic-liver-disease/ for a complete case.
The document provides information about abdominal anatomy and examination, as well as causes and presentations of common abdominal conditions. It discusses:
1. The abdominal regions and organs are outlined, including the liver, gallbladder, pancreas, and intestines.
2. Abdominal pain has somatic and visceral components and can be caused by inflammation, obstruction, ischemia, perforation, or rupture.
3. Acute appendicitis presents with initially vague pain that localizes to the right lower quadrant, along with nausea, fever, and rebound tenderness on exam.
4. Acute pancreatitis has causes including gallstones, alcohol, hyperlipidemia and drugs. It involves activation of pancreatic
Inthis playlist, i discussed various causes for Lower GI Hemorrahage like Hemorrhoids, Fissure in ano, diverticulosis, inflammatory bowel disease and colorectal cancer
Right sided epididymoorchitis with rif abscessElza Emmannual
A 63-year-old man presented with right abdominal pain. He was diagnosed with subhepatic appendicitis based on ultrasound findings and treated conservatively. When his pain did not improve with antibiotics, he was admitted. He later developed right epididymitis, pneumonia, and an abdominal abscess. Exploratory surgery found necrosis of right cord structures and an abscess, which were treated by removing the infected tissue. The patient was discharged after his wound had fully healed.
This document provides an overview of acute gastrointestinal bleeding. It defines upper gastrointestinal bleeding and discusses its causes, including variceal and non-variceal sources. Signs and symptoms are outlined. The approach involves taking a thorough history and physical exam. Key lab tests include CBC, LFTs, coagulation panels and endoscopy. Treatment depends on the bleeding source, and may include endoscopic methods, radiological embolization, surgery, or medications like PPIs and vasoactive drugs. Complications are also reviewed.
This document discusses intestinal obstruction, including its causes, classifications, symptoms, diagnosis and treatment. Some key points:
- Intestinal obstruction can be caused by adhesions, hernias, tumors, strictures and more. It is classified by the obstructed site and presence of blood flow issues.
- Symptoms include pain, vomiting, constipation and distension. Signs depend on obstruction location and duration. Strangulated obstructions require urgent surgery to prevent tissue death.
- Diagnosis involves medical history, physical exam, imaging like x-rays and CT scans. Treatment involves resuscitation, nasogastric drainage, and surgery to relieve the obstruction and address the underlying cause. S
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
More Related Content
Similar to A Case Of Dysphagia- Stricture Esophagus.pptx
1) Gastroesophageal reflux disease (GERD) occurs when gastric contents reflux into the esophagus in excessive amounts, causing symptoms or mucosal injury.
2) Common symptoms include heartburn and regurgitation. Complications include esophagitis, strictures, and Barrett's esophagus.
3) Diagnosis is usually made clinically based on symptoms. Testing with endoscopy, pH monitoring, or impedance monitoring may be used to confirm diagnosis or assess for complications.
4) Treatment involves lifestyle modifications and medication like antacids, H2 blockers, or proton pump inhibitors. Reflux surgery may be considered for severe cases.
The document discusses the anatomy and physiology of the esophagus. It describes the esophagus as a muscular tube that extends from the pharynx to the stomach. It has three portions - cervical, thoracic, and abdominal. The document outlines the relations of the esophagus in each portion and describes conditions like dysphagia, esophageal sphincters, gastroesophageal reflux disease, achalasia, Zenker's diverticulum and their clinical features and treatments.
This document discusses various motility disorders and conditions that affect the esophagus. It begins by describing different types of motility disorders like achalasia and diverticula. It then focuses on achalasia, describing its pathogenesis, clinical presentation, diagnostic tests like esophagram and manometry, and various treatment methods. The document also discusses other topics like esophageal diverticula, benign and malignant neoplasms, perforations, injuries, and acid reflux conditions like Barrett's esophagus. Esophageal manometry is described as the most accurate way to assess motility disorders, and high-resolution manometry is mentioned as an improved technique.
A 59-year-old Chinese man was admitted to the hospital for vomiting blood. He has a history of hepatitis C and is a smoker, drinker, and former drug user. Physical examination found abdominal distension with fluid thrill and shifting dullness. Testing showed signs of liver dysfunction. The provisional diagnosis is esophageal varices secondary to liver disease, likely cirrhosis. Esophageal varices form as a result of portal hypertension in liver disease and can bleed, potentially severely. Treatment focuses on stopping the bleeding and lowering portal pressure through various medical and procedural options.
Intestinal obstruction presentation (Larg & Small Bowel Obstruction).pptxKhansamohamed2
This document discusses intestinal obstruction, including its causes, types, clinical features and management. There are two main types - mechanical (dynamic) obstruction which is due to a physical blockage, and adynamic obstruction which is failure of peristalsis without a blockage. Clinical features include abdominal pain, vomiting, distension and constipation. Management involves relieving the obstruction, resuscitation and treating any underlying cause. Surgery may be needed for cases of strangulation or if conservative measures fail.
DYSPHAGIA By JUSTUS and FLORENCE.pptx vbbwilgusbaraza1
Dysphagia is difficulty swallowing that can involve solids or liquids. It has many potential causes like GERD, esophageal cancer, foreign bodies, corrosive injuries, and neurological disorders. Evaluation involves history, exam, imaging like barium swallow and endoscopy. Management focuses on lifestyle changes, nutrition support, medications, dilation, stenting, radiation/surgery depending on the underlying cause. Complications can include pneumonia, malnutrition, and weight loss if left untreated.
1) Acute intestinal obstruction occurs when intestinal contents cannot move through the bowel lumen. It is most commonly caused by adhesions in the small intestine.
2) Symptoms include abdominal pain, distention, vomiting, and absence of bowel sounds or gas/stool. This leads to fluid and electrolyte imbalances if not treated.
3) Treatment involves NG decompression, IV fluids, and sometimes surgery to remove the obstruction or resect nonviable bowel segments. Nursing care focuses on pain management, prevention of dehydration and complications.
This document discusses non-malignant causes of dysphagia. It begins with anatomy of the oropharynx and esophagus, followed by causes of oropharyngeal and esophageal dysphagia including neurological, muscular, motility and structural issues. Specific motility disorders like achalasia, diffuse esophageal spasm and ineffective esophageal motility are explained. Other esophageal pathologies discussed include strictures, rings, webs, gastroesophageal reflux disease, Barrett's esophagus, diverticula and infectious esophagitis. Investigations and management of various conditions causing non-malignant dysphagia are summarized.
This document presents a case report of a 55-year-old male patient presenting with an indirect inguinal hernia on the right side that had become incarcerated. The patient reported a 2 year history of a reducible inguinal mass that had recently become painful and irreducible. On examination, an irreducible inguinal-scrotal mass was found. The patient underwent hernioplasty with mesh to repair the indirect inguinal hernia. Post-operatively, the patient was discharged with antibiotics and pain medications. The document reviews the clinical presentation, workup, surgical repair, and post-operative care of the patient.
The oesophagus is a 25cm tube connecting the pharynx to the stomach. It has three normal constrictions and consists of four layers. The main muscle layer contains striated muscle in the upper third and smooth muscle in the lower third. Achalasia cardia is failure of the lower oesophageal sphincter to relax during swallowing. Carcinoma of the oesophagus is often caused by smoking and alcohol and spreads locally and via lymph nodes or blood. Barium swallow and endoscopy are used to diagnose it. Treatment depends on the location but may include surgery, radiation, chemotherapy or palliation.
Gallbladder and biliary tract disorders are common, affecting around 20 million people in the US each year. The most common conditions are gallstones and cholecystitis. Gallstones form when bile contains too much cholesterol, bilirubin, or calcium salts. Cholecystitis is inflammation of the gallbladder which can be acute or chronic. Surgical removal of the gallbladder (cholecystectomy) is often required to treat symptomatic gallbladder disease or prevent complications like infection or gallstone obstruction. Nursing care focuses on managing pain, monitoring for complications, and educating patients on signs of issues after surgery.
CHRONIC LIVER DISEASE, CLD, is characterized by chronic abnormal functioning of liver due to various causes including hepatitis, alcoholic liver disease, non-alcoholic liver disease, autoimmune and certain medications.
visit https://surgio.info/chronic-liver-disease/ for a complete case.
The document provides information about abdominal anatomy and examination, as well as causes and presentations of common abdominal conditions. It discusses:
1. The abdominal regions and organs are outlined, including the liver, gallbladder, pancreas, and intestines.
2. Abdominal pain has somatic and visceral components and can be caused by inflammation, obstruction, ischemia, perforation, or rupture.
3. Acute appendicitis presents with initially vague pain that localizes to the right lower quadrant, along with nausea, fever, and rebound tenderness on exam.
4. Acute pancreatitis has causes including gallstones, alcohol, hyperlipidemia and drugs. It involves activation of pancreatic
Inthis playlist, i discussed various causes for Lower GI Hemorrahage like Hemorrhoids, Fissure in ano, diverticulosis, inflammatory bowel disease and colorectal cancer
Right sided epididymoorchitis with rif abscessElza Emmannual
A 63-year-old man presented with right abdominal pain. He was diagnosed with subhepatic appendicitis based on ultrasound findings and treated conservatively. When his pain did not improve with antibiotics, he was admitted. He later developed right epididymitis, pneumonia, and an abdominal abscess. Exploratory surgery found necrosis of right cord structures and an abscess, which were treated by removing the infected tissue. The patient was discharged after his wound had fully healed.
This document provides an overview of acute gastrointestinal bleeding. It defines upper gastrointestinal bleeding and discusses its causes, including variceal and non-variceal sources. Signs and symptoms are outlined. The approach involves taking a thorough history and physical exam. Key lab tests include CBC, LFTs, coagulation panels and endoscopy. Treatment depends on the bleeding source, and may include endoscopic methods, radiological embolization, surgery, or medications like PPIs and vasoactive drugs. Complications are also reviewed.
This document discusses intestinal obstruction, including its causes, classifications, symptoms, diagnosis and treatment. Some key points:
- Intestinal obstruction can be caused by adhesions, hernias, tumors, strictures and more. It is classified by the obstructed site and presence of blood flow issues.
- Symptoms include pain, vomiting, constipation and distension. Signs depend on obstruction location and duration. Strangulated obstructions require urgent surgery to prevent tissue death.
- Diagnosis involves medical history, physical exam, imaging like x-rays and CT scans. Treatment involves resuscitation, nasogastric drainage, and surgery to relieve the obstruction and address the underlying cause. S
Similar to A Case Of Dysphagia- Stricture Esophagus.pptx (20)
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
3. HISTORY OF PRESENTING ILLNESS:
My patient normotensive, normoglycaemic was in usual state of health 3 months
back when he ingested half cup of acid ( sulphuric acid) used for cleaning toilet.
After acid intake he developed persistent vomitting. There were 7 to 8 episodes of
vomiting in which 2 episodes contained blood.
4. Since two and a half month he is not able to swallow anything as he experiences
pain. He was admitted in medical ward and was treated there.
Esophageal stricture was diagnosed on endoscopy and endoscopic dilatation was
done on 27 june 2015.
After endoscopy patient was able to swallow water but not any solid food.
5. Second endoscopy done on 11 july 2015 and diagnosis of esophageal
diverticulum was made. Patient was then referred to surgical unit 1 by medical
department.
history of heart burn, bitter taste in mouth and cough is also present.
6. PAST MEDICAL HISTORY:
No history of diabetes mellitus, hypertension, ischemic heart disease, hepatitis,
tuberculosis and epilepsy.
PAST SURGICAL HISTORY:
there is no history of any previous surgeries.
FAMILY HISTORY:
no history of hypertension, diabetes mellitis, tuberculosis, hepatitis and
ischemic heart disease in the family.
7. PERSONAL HISTORY:
he is married, non-smoker, sleep and bowel habits are normal.
SOCIOECONOMIC HISTORY:
he belongs to low socioeconomic class.
8. SYSTEMIC REVIEW
CARDIOVASCULAR SYSTEM:
there is no history of chest pain, edema feet and palpitations.
GASTROINTESTINAL SYSTEM:
history of decreased appetite, vomitting and heart burn are present.
RESPIRATORY SYSTEM:
history of productive cough on and off. Sputum was white in colour.
no history of dyspnea
9. GENITOURINARY SYSTEM:
no history of polyurea, polydipsia, urgency, frequency, hematuria and flank pain.
CENTRAL NERVOUS SYSTEM:
no history of headache, vertigo, diplopia and visual acquity is normal.
10. GENERAL PHYSICAL EXAMINATION
A young man, wasted in appearance lying on the bed. He is well oriented in time,
person and place. On examination his vital signs are
pulse = 80/min
blood pressure= 100/60 mmhg
temperature = 98 F
respiratory rate = 16/min
11. On examination of hands there is no cyanosis, clubbing, leuconychia, koilonychia,
splinter hemorrhages, sweating, tremors, muscle wasting and palmer erythma.
On examination of head and neck pallour was present, jaundice was absent,
lymph nodes were impalpable, no neck swelling. Thyroid status was normal.
Sacral and pedal edema was absent.
12. On examination of gastrointestinal system
Abdomen soft, non tender
Viscera impalpable
Shifting dullness and fluid thrill absent
Bowel sounds sluggish
13. on examination of cardiovascular system
S1 + S2 + 0
on examination of respiratory system
Bilateral normal vesicular breathing with no added sounds
14. on examination of central nervous system
GCS 15/15
Sensory and motor system intact
18. ULTRASONOGRAPHY : Normal abdominopelvic scan
ENDOSCOPIC FINDINGS:
Esophagus : normal upper and middle third. Stricture at 35 cm from lower incisor.
Dilation done with 10 f balloon. Normal LES.
Stomach : gastric anatomy distorted
Duodenum : could not be visualised
Followed up after 2 weeks for repeat dilatation
19. SECOND ENDOSCOPY FINDINGS
Esophagus : scope passed with some difficulty from piriform fossa to esophagus.
Diverticulum with ulcer noted at 35cm from the lower incisor which end blindly.
20. BARIUM SWALLOW AND MEAL STUDY:
Noted spillage oF contents into trachea.
Study of stomach showed corrosive tight stricture involving pyloric canal and
duodenal bulb.
23. REVIEW of LITERATURE
ESOPHAGUS - gullet
Muscular tubular structure 25 cm long in adults,
10-11 cm in newborns; develops from cranial portion of the foregut; connects
pharynx and stomach;
has cervical, thoracic and abdominal segments
Carries food from pharynx to stomach via peristalsis;
secretes mucin for lubrication
minimize reflux of gastric contents - LES
24. Extends from cricopharyngeus muscle in pharynx (level of C6) to lower esophageal
sphinchter at gastroesophageal junction (T11/T12
25. Cervical (lower border of cricoid cartilage to suprasternal notch / thoracic inlet, 5
cm long, begins 15 cm from incisors); contains striated muscle
Upper thoracic (suprasternal notch to tracheal bifurcation, 5 cm long, begins 20
cm from incisors); has striated and smooth muscle
26. Mid-thoracic (tracheal bifurcation to diaphragmatic hiatus, 5 cm long, begins 24
cm from incisors); has striated and smooth muscle
Lower thoracic and abdominal (10 cm long, begins 30 cm from incisors); extends
past diaphragm to its junction with stomach; has smooth muscle only
27. Usual points of narrowing (possible sites of food / pill lodging):
cricoid cartilage (due to cricopharyngeus muscle),
aortic arch,
anterior crossing of left main bronchus and left atrium, where it passes through
diaphragm.
Gastroesophageal junction proximal limit of gastric rugal folds;
endoscopic definition is Z ("zigzag") line at irregular boundary of squamous and
columnar mucosa in distal esophagus
28.
29. Esophageal sphincters
upper esophageal sphincter is at cricopharyngeus and inferior pharyngeal
constrictor muscles;
lower esophageal sphincter is 2-4 cm proximal to esophagogastric junction at
level of diaphragm (composed of intrinsic esophageal muscles, sling fibers of
proximal stomach and crural diaphragm)
Vagotomy does NOT affect tone of lower esophageal sphincter; tone is affected by
gastrin, acetylcholine and serotonin
30. Arterial blood supply:
cervical region-inferior thyroid artery
upper thoracic-bronchial and intercostal arteries
lower thoracic-aortic branches;
abdominal-left gastric and inferior phrenic arteries
Venous drainage:
extensive submucosal venous plexus
flows into inferior thyroid (upper 1/3),
azygous (middle 1/3) and gastric veins (lower 1/3);
azygous vein empties into superior vena cava and gastric veins into portal system; this connection between caval
and portal venous systems explains esophageal varices due to portal hypertension
31. Nerves: left and right vagus nerves run lateral to esophagus, form plexi along
anterior and posterior surfaces, then reunite to form anterior and posterior vagal
trunks .
Lymphatic drainage:
upper third drains into paratracheal and internal jugular nodes
middle third to mediastinal nodes
lower third to nodes around aorta and celiac axis
32. ESOPHAGEAL STRICTURE
A benign esophageal stricture is a narrowing or tightening of the esophagus that
causes swallowing difficulties.
gastroesophageal reflux disease - esophagitis
a dysfunctional lower esophageal sphincter ---disordered motility
acid ingestion or a hiatal hernia
esophageal surgery laser therapy or photodynamic therapy
33. DIAGNOSIS
X-ray while the patient swallows barium (called a barium study of the esophagus),
by a computerized tomography scan,
by an endoscopy / biopsy.
34. SYMPTOMS
Symptoms of esophageal strictures include heartburn, bitter or acid taste in your
mouth,
choking, coughing, shortness of breath, frequent burping or hiccups,
pain or trouble swallowing, throwing up blood, or weight loss.
36. SURGICAL TREATMENT
The role of surgical treatment in peptic stricture remains in dispute. Indications
include failed aggressive medical therapy or an unsuitable candidate for
aggressive medical therapy. This is usually a rare occurrence in the era of PPI
therapy. Various procedures advocated include the following:
Esophageal-sparing procedures - Standard antireflux surgery (Nissen total or
Belsey partial fundoplication), esophageal lengthening with antireflux surgery
(Collis-Nissen or Belsey gastroplasty)
37. Esophageal resection and reconstruction - Gastric or colon interposition or jejunal
segment
If the benign peptic stricture is dilatable, an esophageal-sparing operation is
performed.
If the length of the esophagus is normal, standard antireflux surgery and
postoperative dilation as necessary is recommended.
38. If the esophagus is short, performing Collis gastroplasty and postoperative
dilation as necessary is recommended.
If the stricture is undilatable, esophageal resection and interposition is
recommended.