A lecture about the management approaches for abdominal vascular injuries. Injury to the major arteries and veins in the abdomen are technical challenge to the surgeon and are often fatal. All vessels are susceptible to injury with penetrating trauma. Vascular injuries in blunt trauma are far less common and usually involve the renal arteries and veins, though all other vessels, including the aorta, can be injured. Blunt trauma results from deceleration, AP compression or pelvic fractures.
Lt hemicolectomy - Surgical Approach, Complications.Vikas V
This is a detailed Presentation of the surgical procedure - Left Hemicolectomy. It deals with the Surgical anatomy, Indications, Surgical Steps, Complications of the Procedure
Tumors of the appendix are rare. They pose both a diagnostic and therapeutic dilemma to the surgeon. The paper discusses the various intricacies of these lesions.
OPEN RIGHT HEMICOLECTOMY- STEP BY STEP OPERATIVE SURGERY
#surgicaleducator #operativesurgery #openrighthemicolectomy #usmle #babysurgeon #surgicaltutor
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• In this video today, I have discussed Open Right Hemicolectomy .
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch all my teaching videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the videos.
Lt hemicolectomy - Surgical Approach, Complications.Vikas V
This is a detailed Presentation of the surgical procedure - Left Hemicolectomy. It deals with the Surgical anatomy, Indications, Surgical Steps, Complications of the Procedure
Tumors of the appendix are rare. They pose both a diagnostic and therapeutic dilemma to the surgeon. The paper discusses the various intricacies of these lesions.
OPEN RIGHT HEMICOLECTOMY- STEP BY STEP OPERATIVE SURGERY
#surgicaleducator #operativesurgery #openrighthemicolectomy #usmle #babysurgeon #surgicaltutor
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• In this video today, I have discussed Open Right Hemicolectomy .
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch all my teaching videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the videos.
thoracic aortic injuries are very rare, this presentation will give a brief idea regarding the presentation of Thoracic aortic injury and its management
extremity vascular injury, arterial injury, causes of arterial injury, mechanisms of arterial injury, investigations for arterial injury, treatment of arterial injury, , extremity vascular injuryfor medical students
Splenic trauma - Causes, Complications, ManagementVikas V
Splenic Trauma - A detailed Presentation about Splenic Trauma, anatomy of the spleen, Causes of Trauma, Mechanism of Injury, Diagnosis, Management, Surgical management, Steps of Splenectomy, and Complications
Extended totally extraperitoneal repair (eTEP) is a novel technique that was first introduced by Jorge Daes in 2012 to address difficult inguinal hernias.
Retrohepatic IVC Injuries Evaluation and Assessment.pptxDr Debmoy Ghatak
Here we discuss Zone IV retroperitoneal injuries i.e Retrohepatic IVC injuries and their exploration In OT, latest guidelines in the management of these fatal injuries and the viable surgical options available to tackle these injuries.
thoracic aortic injuries are very rare, this presentation will give a brief idea regarding the presentation of Thoracic aortic injury and its management
extremity vascular injury, arterial injury, causes of arterial injury, mechanisms of arterial injury, investigations for arterial injury, treatment of arterial injury, , extremity vascular injuryfor medical students
Splenic trauma - Causes, Complications, ManagementVikas V
Splenic Trauma - A detailed Presentation about Splenic Trauma, anatomy of the spleen, Causes of Trauma, Mechanism of Injury, Diagnosis, Management, Surgical management, Steps of Splenectomy, and Complications
Extended totally extraperitoneal repair (eTEP) is a novel technique that was first introduced by Jorge Daes in 2012 to address difficult inguinal hernias.
Retrohepatic IVC Injuries Evaluation and Assessment.pptxDr Debmoy Ghatak
Here we discuss Zone IV retroperitoneal injuries i.e Retrohepatic IVC injuries and their exploration In OT, latest guidelines in the management of these fatal injuries and the viable surgical options available to tackle these injuries.
Infective Endocarditis- surgical indication & principle of surgeryDhaval Bhimani
this presentation is to give idea about surgical indication for Infective Endocarditis and what are the principle of surgery for infective endocarditis.
Ureteric injury in Gyenec Surgery, Serious complication of gynecologic surgery
Significant morbidity and long-term sequelae
Uncommon in benign gynecologic surgery
Vaginal hysterectomy has the lowest rate of ureteral injury
Laparoscopic hysterectomy has the highestThe ureters are the muscular ,thick walled narrow tubes(Right and Left)
Each measures 25-30 cm in length and extends from renal pelvis to its entry in the bladder.The ureter are located retroperitonealy and run from the renal pelvic to urinary bladder.
First part –Enter the pelvis by crossing the common iliac vessel from lateral to medial aspect at their bifurcation just medial to ovarian vessel and run downwards along with greater sciatic notch & reaches ischial spine.
Acute appendicitis is a condition in which appendix get inflammed and cause extreme pain , we can diagnose it clinically by different clinical tests and decide whether to treat it medically or go for surgery. Further different types of appendix surgery i.e. open appendectomy and laproscopic appendectomy are also explained. All the steps of appendectomy are also explained in it.
visit my youtube channel ' medical tribe ' for more medical related content, here is the link of it ; https://www.youtube.com/channel/UCM19PdhYFnUTWvKnq2PoLAQ
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
1. ABDOMINAL VASCULAR
INJURIES
PROFESSOR
ABDULSALAM Y TAHA
School of Medicine
University of Sulaimani
Iraq
https://sulaimaniu.academia.edu/AbdulsalamTaha
2. INTRODUCTION
• Injury to the major arteries and veins in the
abdomen are technical challenge to the surgeon
and are often fatal.
• All vessels are susceptible to injury with
penetrating trauma.
• Vascular injuries in blunt trauma are far less
common and usually involve the renal arteries
and veins, though all other vessels, including the
aorta, can be injured.
• Blunt trauma results from: deceleration, AP
compression or pelvic fractures.
3. History
• DeBakey and Simeone (1946, Ann Surg)
2,471 arterial injuries during WWII
49 AVI (2%)
• Rich et al. (1970, J Trauma)
1,000 arterial injuries during Vietnam War
29 AVI (2.9%)
• Clouse, et al. (2007, J Am Coll Surg)
301 vascular injuries during Operation Iraqi
Liberation (Freedom)
18 AVI (6%)
4. Diagnosis
• Critical patient:
exploratory
laparotomy.
• Stable patient:
plain film: GSW
trajectory and pelvic
fractures.
CT/Angiography:
useful in late
penetrating trauma.
6. • Several vessels are notoriously difficult to
expose. These include the retrohepatic
IVC; suprarenal aorta; the celiac axis; the
proximal SMA; the junction of the SMV,
splenic, and portal veins; and the
bifurcation of the vena cava.
• Maneuvers have been described to aid in
the exposure of all of these vessels.
8. ZONES OF INJURY
1. Zone II:
2. Lateral RP
Zone III: Pelvis
Zone I
Zone I:
RP midline
From hiatus to
Sacrum.
9. LEFT MEDIAL VISCERAL
ROTATION
• This maneuver is used to expose the suprarenal
aorta, celiac axis, proximal SMA and left renal
arteries.
• This is accomplished by incising the left lateral
peritoneal reflection beginning at the distal
descending colon and extending the incision
past the splenic flexure, around the posterior
aspect of the spleen, behind the gastric fundus,
and ending at the oesophagus.
12. LEFT MEDIAL VISCERAL ROTATION
• This incision permits the left colon, spleen,
pancreas, and stomach to be rotated
toward the midline.
• Division of the left crus of the diaphragm
will permit access to the aorta above the
celiac axis.
• The maneuver is much more difficult and
time consuming than it first appears.
13. RIGHT MEDIAL VISCERAL ROTATION
• Mobilization of the right colon and a
Kocher maneuver will expose the entire
vena cava except the retrohepatic portion.
• It is technically simple.
• The kidney can be left in situ or mobilized
with the remaining viscera with both right
and left medial rotations.
16. • The junction of the SMV, splenic, and portal
veins can be exposed in elective surgery by
dissecting the vessels from the pancreas as
required when performing a distal spleno-renal
shunt.
• However, in the presence of massive bleeding
from a venous injury, this may be impossible.
• Therefore, in trauma surgery, the neck of the
pancreas is divided without hesitation. This
provides excellent exposure of this difficult area.
17.
18.
19. IVC BIFURCATION
• The bifurcation of the IVC is obscured by
the right common iliac artery.
• This vessel should be divided to expose
extensive vena caval injuries of this area.
• The artery MUST be repaired after the
venous injury is treated or AMPUTATION
occurs in as many as 50% of patients.
22. PELVIC VASCULAR ISOLATION
• As the dissection continues, the
clamps are moved progressively
closer to the vascular injuries until
definitive control of hemorrahage is
achieved.
23. Emergent Abdominal Exploration
• All abdominal explorations in adults are
performed using a long midline incision.
• For children under the age of 6, a transverse
incision may be advantageous.
• The incision should be made with a scalpel
rather than with a cautery because it is faster.
• Liquid and clotted blood is rapidly evacuated
with multiple laparotomy pads and suction.
• Additional pads are then placed in each
quadrant to localize haemorrhage.
• The aorta is palpated to assess blood pressure.
24. Emergent Abdominal Exploration
• If exsanguinating haemorrhage is
encountered upon opening the abdomen,
it is usually caused by injury to the liver,
aorta, IVC, or iliac vessels.
• If the liver is the source, the hepatic
pedicle should be immediately clamped
( a Pringle maneuver) and the liver
compressed posteriorly by packing.
26. Emergent Abdominal Exploration
• If exsanguinating haemorrhage originates near
the midline in the retroperitoneum, direct manual
pressure is applied with a laparotomy pad and
the aorta is exposed at the diaphragmatic hiatus
and clamped.
• The same approach is used in the pelvis except
that infrarenal aorta can be clamped, which is
both easier and safer because splachnic and
renal ischaemia can be avoided.
27. Emergent Abdominal exploration
• Injuries of the iliac vessels pose a unique
problem for emergency vascular control.
• Because they are so many large vessels in
proximity, multiple vascular injuries are common.
• Furthermore, venous injuries are not controlled
with aortic clamping.
• A helpful maneuver in these circumstances is
pelvic vascular isolation.
• For stable patients with large midline
haematomas, clamping the aorta proximal to
the haematoma is also a wise precaution.
28. Emergent Abdominal Exploration
• All abdominal organs are systematically
examined by visualization, palpation, or both.
Missed injuries are a serious problem with often
fatal results.
• In penetrating trauma missed injuries can occur
if wound tracks are not completely explored or
due to failure to explore retroperitoneal
structures such as the ascending and
descending colons, the second and third
portions of the duedenum, and ureters.
29. Emergent Abdominal Exploration
• Furthermore, injuries of the aorta or IVC may be
temporarily tamponated by overlying structures.
• If the retroperitoneum is opened and the injury
overlooked, delayed massive haemorrhage may
occur following abdominal closure.
• Blunt abdominal injuries are usually obvious, but
injuries of the pancreas, duodenum, bladder,
and even aorta can be overlooked.
30. Endovascular options?
• There are limited case series and reports.
• Contraindicated in
1. hemodynamically unstable patients.
2. in the presence of other injuries requiring
exploration.
3. Lower limb ischemia
• Blunt injuries causing intimal disruption are
more amenable to endovascular therapy.
N/B., Intimal disruption is the most common
cause of renal artery injury.
31.
32.
33. SUMMARY
• Up to 25% of patients with abdominal trauma may have
major vascular injury.
• Shock out of proportion to the extent of external injury
suggests abdominal vascular injury.
• Isolated abdominal injury in patients with shock suggests
major vascular injury that requires emergency laparotomy
for control.
• After the abdomen is entered, immediate control of the
supraceliac aorta should be considered before continuing
the operation.
• Retroperitoneal hematomas should not be explored right
away unless they are actively bleeding.
• Stopping the procedure after the initial exploration for
damage control to allow time for resuscitation in the
intensive care unit is often a reasonable initial treatment.
• If the patient’s condition allows and if endovascular
methods are available, consider placing an aortic balloon
from the left brachial artery for temporary occlusion