Biliārā atrēzija pediatrijā
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Acute Limb Ischemia
Acute limb ischemia is a sudden decrease in blood flow to a limb that threatens viability. It requires urgent evaluation and management to determine if the limb is viable, threatened, or irreversibly damaged. Prompt diagnosis and revascularization through catheter-based thrombolysis, thrombectomy, or surgery can reduce limb loss risk. Treatment approaches depend on the severity of ischemia and limb threat.
Mechanical Thrombectomy
Mechanical thrombectomy devices show some advantages for treating deep vein thrombosis (DVT) but have limitations as standalone therapies. When used in combination with thrombolytics, mechanical thrombectomy can speed lysis, potentially reduce lytic doses and treatment time, and allow treatment of patients who cannot receive thrombolytics. However, data on their long-term safety and efficacy compared to thrombolysis alone is still limited. Standalone mechanical thrombectomy often provides only partial clot removal for DVT.
prophylatic inferior vena cava (IVC) filters in trauma
This document summarizes a multicenter randomized controlled trial that evaluated the use of retrievable inferior vena cava (IVC) filters for thromboprophylaxis in severely injured trauma patients. The trial randomized 240 patients with contraindications to anticoagulation and Injury Severity Score >15 to either receive an IVC filter within 72 hours or no filter. The primary endpoints were symptomatic pulmonary embolism and death within 90 days. Secondary endpoints included DVT rates, bleeding complications, and costs. Preliminary results found the groups to be balanced at baseline. The study aims to determine if early IVC filter placement reduces pulmonary embolism rates compared to no filter in high-risk trauma patients who cannot receive antico
Dynamic auscultation
This document describes techniques for dynamic auscultation of the heart by altering circulatory dynamics through physiological and pharmacological maneuvers. Some key techniques discussed include respiration, postural changes, Valsalva maneuver, isometric exercise, and use of vasoactive agents. Various maneuvers cause changes in heart sounds and murmurs due to effects on hemodynamics, ventricular volumes, and pressures. For example, inspiration augments murmurs on the right side of the heart while expiration accentuates some left-sided murmurs. The Valsalva maneuver and post-premature ventricular contractions also cause characteristic changes heard on auscultation.
CT Imaging of Cerebral Ischemia and Infarction
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Biliary drainage
This document discusses percutaneous transhepatic biliary drainage (PTBD) for the treatment of malignant biliary obstruction. PTBD involves puncturing the obstructed bile duct under imaging guidance and placing a drainage catheter to decompress the biliary system. It is indicated for palliation or as a preoperative procedure. Complications can include pain, bile leaks, hemorrhage, cholangitis, and stent blockage over time. The procedure involves imaging to plan access, puncturing the bile duct with a needle, placing a wire and catheter across the stricture, and sometimes placing a stent to maintain drainage.
Cardiophrenic angle
The cardiophrenic angle is formed between the heart and diaphragm. There are left and right cardiophrenic angles. Blunting of the cardiophrenic angle suggests a fluid effusion, though the right angle can sometimes be obscured by the cardiohepatic angle between the heart and liver. The cardiophrenic angle provides information about potential fluid buildup in the space between the lungs and chest wall.
Radiological findings of pleural effussion
Pleural effusion can result from a number of conditions, such as congestive heart failure, pneumonia, cancer, liver cirrhosis, and kidney disease. [1] The characteristics of the fluid depend on the underlying pathophysiologic mechanism. The fluid can be transudate, nonpurulent exudate, pus, blood, or chyle. Imaging studies are valuable in detecting and managing pleural effusions but not in accurately characterizing the biochemical nature of the fluid.
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Acute Limb Ischemia
Acute limb ischemia is a sudden decrease in blood flow to a limb that threatens viability. It requires urgent evaluation and management to determine if the limb is viable, threatened, or irreversibly damaged. Prompt diagnosis and revascularization through catheter-based thrombolysis, thrombectomy, or surgery can reduce limb loss risk. Treatment approaches depend on the severity of ischemia and limb threat.
Mechanical Thrombectomy
Mechanical thrombectomy devices show some advantages for treating deep vein thrombosis (DVT) but have limitations as standalone therapies. When used in combination with thrombolytics, mechanical thrombectomy can speed lysis, potentially reduce lytic doses and treatment time, and allow treatment of patients who cannot receive thrombolytics. However, data on their long-term safety and efficacy compared to thrombolysis alone is still limited. Standalone mechanical thrombectomy often provides only partial clot removal for DVT.
prophylatic inferior vena cava (IVC) filters in trauma
This document summarizes a multicenter randomized controlled trial that evaluated the use of retrievable inferior vena cava (IVC) filters for thromboprophylaxis in severely injured trauma patients. The trial randomized 240 patients with contraindications to anticoagulation and Injury Severity Score >15 to either receive an IVC filter within 72 hours or no filter. The primary endpoints were symptomatic pulmonary embolism and death within 90 days. Secondary endpoints included DVT rates, bleeding complications, and costs. Preliminary results found the groups to be balanced at baseline. The study aims to determine if early IVC filter placement reduces pulmonary embolism rates compared to no filter in high-risk trauma patients who cannot receive antico
Dynamic auscultation
This document describes techniques for dynamic auscultation of the heart by altering circulatory dynamics through physiological and pharmacological maneuvers. Some key techniques discussed include respiration, postural changes, Valsalva maneuver, isometric exercise, and use of vasoactive agents. Various maneuvers cause changes in heart sounds and murmurs due to effects on hemodynamics, ventricular volumes, and pressures. For example, inspiration augments murmurs on the right side of the heart while expiration accentuates some left-sided murmurs. The Valsalva maneuver and post-premature ventricular contractions also cause characteristic changes heard on auscultation.
CT Imaging of Cerebral Ischemia and Infarction
Definition of stroke and cerebrovascular disorders and pathophysiology of cerebral infarct and CT imaging overview of acute-subacute and chronic infarcts and penumbra.
causes of cerebral edema , Radiological signs of acute infarct and hemorrhagic infarct and comparison of MRI and CT in the diagnosis of acute infarct
Role of diffusion weighted imaging (DWI) and diffusion perfusion mismatch
Biliary drainage
This document discusses percutaneous transhepatic biliary drainage (PTBD) for the treatment of malignant biliary obstruction. PTBD involves puncturing the obstructed bile duct under imaging guidance and placing a drainage catheter to decompress the biliary system. It is indicated for palliation or as a preoperative procedure. Complications can include pain, bile leaks, hemorrhage, cholangitis, and stent blockage over time. The procedure involves imaging to plan access, puncturing the bile duct with a needle, placing a wire and catheter across the stricture, and sometimes placing a stent to maintain drainage.
Cardiophrenic angle
The cardiophrenic angle is formed between the heart and diaphragm. There are left and right cardiophrenic angles. Blunting of the cardiophrenic angle suggests a fluid effusion, though the right angle can sometimes be obscured by the cardiohepatic angle between the heart and liver. The cardiophrenic angle provides information about potential fluid buildup in the space between the lungs and chest wall.
Radiological findings of pleural effussion
Pleural effusion can result from a number of conditions, such as congestive heart failure, pneumonia, cancer, liver cirrhosis, and kidney disease. [1] The characteristics of the fluid depend on the underlying pathophysiologic mechanism. The fluid can be transudate, nonpurulent exudate, pus, blood, or chyle. Imaging studies are valuable in detecting and managing pleural effusions but not in accurately characterizing the biochemical nature of the fluid.
ACUTE MESENTERIC ISCHAEMIA
Acute mesenteric ischemia is a life-threatening condition caused by interrupted blood flow to the intestines. It has a high mortality rate of 60-80% if not treated promptly. The document discusses the definition, causes, clinical presentation, diagnostic tests and management of acute mesenteric ischemia. Key diagnostic tests include bloodwork, abdominal imaging like CT angiography and angiography. Treatment involves fluid resuscitation, antibiotics, stopping vasoconstrictors, and often emergency surgery to revascularize the intestines or resect non-viable bowel segments. Prompt diagnosis and treatment are critical given the rapid progression of intestinal tissue damage from ischemia.
Constrictive pericarditis
The document discusses constrictive pericarditis, providing details on:
1) The pathology of constrictive pericarditis which involves thickening and scarring of the pericardium leading to loss of elasticity.
2) The pathophysiology of constrictive pericarditis where the inelastic pericardium constrains cardiac filling and prevents adaptation to volume changes.
3) Key diagnostic features of constrictive pericarditis seen on echocardiogram include septal bounce, rapid early diastolic mitral inflow, and increased mitral annular velocities that rise with inspiration.
Imaging in stroke
Stroke is a suuden onset neurologic deficit. Imaging plays an important role in early diagnosis and timely treatment.
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The document describes the venous drainage system of the lower extremity, including the long saphenous vein (LSV), short saphenous vein (SSV), deep veins, and perforating veins. It provides details on the anatomy and course of the LSV and SSV. Surgical procedures for varicose veins are discussed such as ligation and stripping, ligation of incompetent perforators, and newer minimally invasive techniques like foam sclerotherapy, endovenous laser ablation, and radiofrequency ablation. Post-operative care and potential complications are also summarized.
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This document provides an overview of ECG interpretation, including conduction pathways, a systematic method of interpretation, and common abnormalities seen in critical care. It discusses supraventricular and ventricular arrhythmias, bundle branch blocks, heart block, and life-threatening arrhythmias such as ventricular tachycardia, ventricular fibrillation, and asystole. It also covers the basics of 12-lead ECG interpretation including lead placement and axis.
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1. Acute appendicitis is caused by obstruction of the appendix lumen, leading to increased intraluminal pressure, edema, and bacterial invasion.
2. The classic presentation includes initially vague periumbilical pain that later localizes to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever.
3. On examination, tenderness is elicited over McBurney's point with guarding and rebound tenderness. Diagnosis is suggested by clinical scoring systems and confirmed by ultrasound or CT scan showing a thick-walled, inflamed appendix.
Peripheral arterial doppler
This document discusses Doppler ultrasonography and the spectral waveforms used to analyze blood flow patterns in vessels. It provides details on:
- The Doppler spectrum which represents blood flow velocities over time on a graph with frequency on the vertical axis and time on the horizontal axis.
- Characteristics of normal flow patterns seen in major vessels and how they relate to vessel anatomy and organ function.
- Abnormal flow patterns seen in pseudoaneurysms and arteriovenous fistulas which involve damage to vessel walls. Specific waveform patterns are described that indicate these conditions.
Coronary angiogram
Coronary angiography is a procedure that uses dye and x-rays to see how blood flows through the coronary arteries of the heart. It is the gold standard for evaluating coronary artery disease and can identify the location and severity of any blockages. A coronary angiogram involves inserting a catheter into the heart and injecting dye so that blockages are highlighted on x-ray images. Potential complications are rare but can include heart attack, stroke, or kidney injury from the dye. The results of the angiogram are used to determine if further procedures like angioplasty or bypass surgery are needed.
Continuous Murmurs
This document discusses continuous murmurs, which are murmurs that begin in systole and continue uninterrupted through diastole. The main causes of continuous murmurs are high to low pressure shunts, such as a patent ductus arteriosus (PDA) or ruptured sinus of valsalva. Continuous murmurs can also be caused by rapid blood flow, such as in hyperthyroidism. The document describes the characteristics, locations, and distinguishing features of continuous murmurs from various underlying conditions.
Congenital heart disease and vascular abnormality(x-ray findings)
This document provides an overview of various congenital heart diseases and vascular abnormalities, describing their characteristics and classic radiographic signs. It defines common conditions like transposition of the great vessels, total anomalous pulmonary venous return, partial anomalous pulmonary venous return, endocardial cushion defects, tetralogy of Fallot, aortic coarctation, Ebstein's anomaly. For each condition, it explains the anatomical features and identifies signature radiographic patterns seen on chest x-rays, like the "egg on string sign" and "snowman sign".
Radiological anatomy & Techniques of the Ventricular system
This document provides information on the ventricular system of the brain. It describes the lateral ventricles, third ventricle, cerebral aqueduct, and fourth ventricle. It discusses the relations, choroid plexuses, and radiological appearance of each part of the ventricular system. Radiological features on plain X-rays, CT, and MRI are also summarized.
Acute coronary syndrome
Acute Coronary Syndrome (ACS) encompasses a spectrum of conditions caused by reduced blood flow in the coronary arteries, including unstable angina and myocardial infarction (MI). It is typically diagnosed through a patient's symptoms, electrocardiogram (ECG) findings, and cardiac biomarker levels. For ACS patients presenting within 12 hours of symptoms, guidelines recommend obtaining an ECG within 10 minutes and starting reperfusion therapies like thrombolysis within 30 minutes to minimize heart muscle damage. Diagnosis is based on criteria including typical chest pain, ECG changes, and elevated troponin levels. Outcomes are generally worse in elderly patients and those with atypical presentations and longer treatment delays.
ECG Changes in Myocardial Infarction
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This document discusses Doppler ultrasound of carotid arteries. It begins with the anatomy of carotid arteries and then discusses normal Doppler ultrasound findings of the carotid arteries including flow patterns and spectral waveforms. It describes various pathologies that can cause carotid artery disease such as atherosclerosis and other non-atherosclerotic diseases. It also discusses how diseases outside the carotid arteries can affect them. The document provides detailed information on ultrasound techniques for evaluating the carotid arteries and interpreting ultrasound findings for plaque characterization and grading stenosis.
Mrcp radiology
This document provides an overview of magnetic resonance cholangiopancreatography (MRCP). It discusses patient preparation, techniques, advantages, limitations, and clinical applications of MRCP. Key points include: MRCP uses heavily T2-weighted sequences to noninvasively visualize the biliary and pancreatic ducts. Patient preparation involves fasting and administering oral contrast. Thin-slab MRCP images provide high resolution of the ductal systems. MRCP is useful for evaluating biliary diseases, pancreatic diseases, and postoperative complications without radiation exposure. Limitations include inability to detect small stones and artifacts from gas or metal.
BMV,PTMC,BALLOON MITRAL VALVOTOMY, BAL, VIRBHAN BALAI, DR VIRBHAN
This document discusses balloon mitral valvuloplasty (BMV) and balloon aortic valvuloplasty (BAV). It describes the indications for BMV as symptomatic or asymptomatic severe mitral stenosis. The Inoue technique for BMV is explained in detail, including transseptal puncture and sequential balloon inflation. Complications of BMV include severe mitral regurgitation, mortality, and cardiac perforation. BAV was used historically but was abandoned due to high restenosis rates and no improvement in patient survival.
Imaging in Paediatric Intestinal Obstruction
The document discusses various causes of paediatric intestinal obstruction. It begins by outlining normal neonatal bowel gas patterns and developmental lesions of the intestinal tract that can lead to obstruction. It then describes the two main types of intestinal obstruction - upper and lower. Common causes are discussed for each type, including oesophageal atresia, hypertrophic pyloric stenosis, duodenal atresia, malrotation, and jejunal atresia. Key imaging features of common lesions are summarized.
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ACUTE MESENTERIC ISCHAEMIA
Acute mesenteric ischemia is a life-threatening condition caused by interrupted blood flow to the intestines. It has a high mortality rate of 60-80% if not treated promptly. The document discusses the definition, causes, clinical presentation, diagnostic tests and management of acute mesenteric ischemia. Key diagnostic tests include bloodwork, abdominal imaging like CT angiography and angiography. Treatment involves fluid resuscitation, antibiotics, stopping vasoconstrictors, and often emergency surgery to revascularize the intestines or resect non-viable bowel segments. Prompt diagnosis and treatment are critical given the rapid progression of intestinal tissue damage from ischemia.
Constrictive pericarditis
The document discusses constrictive pericarditis, providing details on:
1) The pathology of constrictive pericarditis which involves thickening and scarring of the pericardium leading to loss of elasticity.
2) The pathophysiology of constrictive pericarditis where the inelastic pericardium constrains cardiac filling and prevents adaptation to volume changes.
3) Key diagnostic features of constrictive pericarditis seen on echocardiogram include septal bounce, rapid early diastolic mitral inflow, and increased mitral annular velocities that rise with inspiration.
Imaging in stroke
Stroke is a suuden onset neurologic deficit. Imaging plays an important role in early diagnosis and timely treatment.
Varicose vein ppt (thu)
The document describes the venous drainage system of the lower extremity, including the long saphenous vein (LSV), short saphenous vein (SSV), deep veins, and perforating veins. It provides details on the anatomy and course of the LSV and SSV. Surgical procedures for varicose veins are discussed such as ligation and stripping, ligation of incompetent perforators, and newer minimally invasive techniques like foam sclerotherapy, endovenous laser ablation, and radiofrequency ablation. Post-operative care and potential complications are also summarized.
ECG interpretation: the basics
This document provides an overview of ECG interpretation, including conduction pathways, a systematic method of interpretation, and common abnormalities seen in critical care. It discusses supraventricular and ventricular arrhythmias, bundle branch blocks, heart block, and life-threatening arrhythmias such as ventricular tachycardia, ventricular fibrillation, and asystole. It also covers the basics of 12-lead ECG interpretation including lead placement and axis.
Clinical examination of abdominal lump
This is extremely beneficial for clinicians engaged in medical practise as it shows how to examine abdominal lump.
Diastolic murmurs
Dr Muhammed Aslam
Junior Resident
Pulmonary Medicine
ACME Pariyaram
Presented at Sahakarana Hrudayalaya
Acute appendicitis &lump
1. Acute appendicitis is caused by obstruction of the appendix lumen, leading to increased intraluminal pressure, edema, and bacterial invasion.
2. The classic presentation includes initially vague periumbilical pain that later localizes to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever.
3. On examination, tenderness is elicited over McBurney's point with guarding and rebound tenderness. Diagnosis is suggested by clinical scoring systems and confirmed by ultrasound or CT scan showing a thick-walled, inflamed appendix.
Peripheral arterial doppler
This document discusses Doppler ultrasonography and the spectral waveforms used to analyze blood flow patterns in vessels. It provides details on:
- The Doppler spectrum which represents blood flow velocities over time on a graph with frequency on the vertical axis and time on the horizontal axis.
- Characteristics of normal flow patterns seen in major vessels and how they relate to vessel anatomy and organ function.
- Abnormal flow patterns seen in pseudoaneurysms and arteriovenous fistulas which involve damage to vessel walls. Specific waveform patterns are described that indicate these conditions.
Coronary angiogram
Coronary angiography is a procedure that uses dye and x-rays to see how blood flows through the coronary arteries of the heart. It is the gold standard for evaluating coronary artery disease and can identify the location and severity of any blockages. A coronary angiogram involves inserting a catheter into the heart and injecting dye so that blockages are highlighted on x-ray images. Potential complications are rare but can include heart attack, stroke, or kidney injury from the dye. The results of the angiogram are used to determine if further procedures like angioplasty or bypass surgery are needed.
Continuous Murmurs
This document discusses continuous murmurs, which are murmurs that begin in systole and continue uninterrupted through diastole. The main causes of continuous murmurs are high to low pressure shunts, such as a patent ductus arteriosus (PDA) or ruptured sinus of valsalva. Continuous murmurs can also be caused by rapid blood flow, such as in hyperthyroidism. The document describes the characteristics, locations, and distinguishing features of continuous murmurs from various underlying conditions.
Congenital heart disease and vascular abnormality(x-ray findings)
This document provides an overview of various congenital heart diseases and vascular abnormalities, describing their characteristics and classic radiographic signs. It defines common conditions like transposition of the great vessels, total anomalous pulmonary venous return, partial anomalous pulmonary venous return, endocardial cushion defects, tetralogy of Fallot, aortic coarctation, Ebstein's anomaly. For each condition, it explains the anatomical features and identifies signature radiographic patterns seen on chest x-rays, like the "egg on string sign" and "snowman sign".
Radiological anatomy & Techniques of the Ventricular system
This document provides information on the ventricular system of the brain. It describes the lateral ventricles, third ventricle, cerebral aqueduct, and fourth ventricle. It discusses the relations, choroid plexuses, and radiological appearance of each part of the ventricular system. Radiological features on plain X-rays, CT, and MRI are also summarized.
Acute coronary syndrome
Acute Coronary Syndrome (ACS) encompasses a spectrum of conditions caused by reduced blood flow in the coronary arteries, including unstable angina and myocardial infarction (MI). It is typically diagnosed through a patient's symptoms, electrocardiogram (ECG) findings, and cardiac biomarker levels. For ACS patients presenting within 12 hours of symptoms, guidelines recommend obtaining an ECG within 10 minutes and starting reperfusion therapies like thrombolysis within 30 minutes to minimize heart muscle damage. Diagnosis is based on criteria including typical chest pain, ECG changes, and elevated troponin levels. Outcomes are generally worse in elderly patients and those with atypical presentations and longer treatment delays.
ECG Changes in Myocardial Infarction
cardiac, cardiology, ecg, electrocardiogram, heart, st elevation, angina, medical, medicine, heart attack,
Doppler ultrasound of carotid arteries
This document discusses Doppler ultrasound of carotid arteries. It begins with the anatomy of carotid arteries and then discusses normal Doppler ultrasound findings of the carotid arteries including flow patterns and spectral waveforms. It describes various pathologies that can cause carotid artery disease such as atherosclerosis and other non-atherosclerotic diseases. It also discusses how diseases outside the carotid arteries can affect them. The document provides detailed information on ultrasound techniques for evaluating the carotid arteries and interpreting ultrasound findings for plaque characterization and grading stenosis.
Mrcp radiology
This document provides an overview of magnetic resonance cholangiopancreatography (MRCP). It discusses patient preparation, techniques, advantages, limitations, and clinical applications of MRCP. Key points include: MRCP uses heavily T2-weighted sequences to noninvasively visualize the biliary and pancreatic ducts. Patient preparation involves fasting and administering oral contrast. Thin-slab MRCP images provide high resolution of the ductal systems. MRCP is useful for evaluating biliary diseases, pancreatic diseases, and postoperative complications without radiation exposure. Limitations include inability to detect small stones and artifacts from gas or metal.
BMV,PTMC,BALLOON MITRAL VALVOTOMY, BAL, VIRBHAN BALAI, DR VIRBHAN
This document discusses balloon mitral valvuloplasty (BMV) and balloon aortic valvuloplasty (BAV). It describes the indications for BMV as symptomatic or asymptomatic severe mitral stenosis. The Inoue technique for BMV is explained in detail, including transseptal puncture and sequential balloon inflation. Complications of BMV include severe mitral regurgitation, mortality, and cardiac perforation. BAV was used historically but was abandoned due to high restenosis rates and no improvement in patient survival.
Imaging in Paediatric Intestinal Obstruction
The document discusses various causes of paediatric intestinal obstruction. It begins by outlining normal neonatal bowel gas patterns and developmental lesions of the intestinal tract that can lead to obstruction. It then describes the two main types of intestinal obstruction - upper and lower. Common causes are discussed for each type, including oesophageal atresia, hypertrophic pyloric stenosis, duodenal atresia, malrotation, and jejunal atresia. Key imaging features of common lesions are summarized.
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Congenital heart disease and vascular abnormality(x-ray findings)
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BMV,PTMC,BALLOON MITRAL VALVOTOMY, BAL, VIRBHAN BALAI, DR VIRBHAN
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Jaundzimušais
pediatrija. Izmantotie avoti:
Kreicberga I, Rezeberga D. “Dzemdniecība” Rīga 2009. 115.-125. lpp.
Plaster C http://people.umass.edu/mva/pdf/Neonatal_Reflexes_07.pdf Citēts: 25.10.2011. 19:15
Sviridova D. Lekcija: “Jaundzimušie: refleksi, gestācijas vecums, adaptācijas perioda norises”.
Gardovska D. “Mācību metodieskie materiāli pediatrijā. Modificētās slimības vēstures shēma MF studentiem”. Rīga 2005. 8-14. lpp.
Behrman RE “Nelson Textbook of pediatrics 17ed” Elsiever science (USA) 2004. 28 – 30 pp.
Neurocisticercosis Jorge
El documento habla sobre la neurocisticercosis, una infestación del sistema nervioso central causada por quistes larvarios del parásito Taenia solium. Explica que los humanos actúan como huéspedes intermediarios accidentales al ingerir los huevos del parásito. Describe el ciclo evolutivo del parásito y los métodos de diagnóstico como la tomografía computarizada, que puede detectar los quistes en el cerebro. Finalmente, aborda las opciones de tratamiento disponibles para esta afección.
Neurocisticercosis
Este documento trata sobre la neurocisticercosis. Resume su epidemiología, fisiopatología, manifestaciones clínicas, diagnóstico, tratamiento y pronóstico. Explica que la neurocisticercosis es causada por la larva del parásito Taenia solium en el sistema nervioso central y es una causa común de epilepsia. Describe los diferentes estadios y formas clínicas de la enfermedad y los métodos para diagnosticarla y tratarla, incluyendo medicamentos y cirugía.
Neurocisticercosis ARP
La neurocisticercosis es una enfermedad parasitaria común del sistema nervioso central causada por la larva de la Taenia solium. Es endémica en países en desarrollo como México y es una causa frecuente de epilepsia secundaria. Los síntomas pueden incluir convulsiones, cefalea, alteraciones de la visión y psiquiátricas. El diagnóstico se basa en la epidemiología, estudios de imagen como TC y RMN, y pruebas serológicas. El tratamiento incluye medicamentos antiparasitarios y en
Neurocisticercosis
La neurocisticercosis es una infección del sistema nervioso central causada por la larva del tenia Taenia solium. Afecta principalmente a países de América Latina, Asia y África. Puede presentarse de forma parenquimatosa, subaracnoidea, ventricular o espinal, causando crisis epilépticas, cefalea, hidrocefalia u otros síntomas neurológicos, dependiendo de su localización. El diagnóstico se basa en la combinación de antecedentes clínicos, pruebas de laboratorio e imágenes médic
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Biliārā atrēzija pediatrijā
- 1. Biliārā atrēzija pediatrijā st.med. Aleksandrs Šapovalovs RSU MF5 5.grupa 1
- 2. 2 Biliārās sistēmas anatomija D.hepaticus dexter et sinister D.hepaticus communis D.cysticus Vesica fellae D.choledochus Papilla Vateri Par descendens duodeni
- 3. 3 Jaundzimušo biliārā atrēzija Primārā ţultsceļu necaurejamība Dekompensēta holestāze Progresējošā biliārā hipertenzija Sekundārā biliārā ciroze 65-90% izolēta patoloģija 10-35% kombinējas ar aspleniju, situs inversus
- 4. 4 Anatomiskie varianti I tips D.choledochus II tips D.hepaticus communis III tips D.hepaticus dx D.hepaticus sin
- 5. 5 Teorija Patoģenēze Epidemioloģija Nav skaidra 1/10.000-15.000 Raksturīgs iekaisums Dzīvildze pēc BDA Toksiskie aģenti? 5 gadi 47-60% Infekcija? 10 gadi 25-35% Rota vīruss? CMV? Bieţāk meitenēm
- 6. 6 Klīnika Icterus mechanicus Difūzā dzelte Tumšs urīns Gaišas fēces Attīstība pirmās nedēļās normāla Retāk Hepatosplenomegālija Portālā hipertenzija Kardioloģiskās patoloģijas
- 7. 7 Laboratoriski Hiperbilirubinēmija uz tieša bilirubīna frakcijas rēķina vēlāk – arī netiešā frakcija SF↑ Aknu transferāzes↑ pie parenhīmas bojājumiem
- 8. 8 Neinvazīvā radioloģija USG in utero Jūtība 80% Biliārās sistēmas dilatācija Aizprostojuma vieta Cistas? Divertikuļi? MR bilipankreatogrāfija +/ Scintigrāfija Hepatobiliary iminodiacetic acid (HIDA) scan
- 9. 9 Biopsija • Perkutānā biopsija USG kontrolē • Jūtīgums un specifiskums ap 90% • Pirmās 2 nedēļās bieţi jūtīgums zems, jo holestātiskais aknu bojājums sekundārs
- 10. 10 ERHPG Mūsdienās kļūst iespējams progresēt endoskopiskajam aprīkojumam Stentēšanas iespēja
- 11. 11 Intraoperatīvie izmeklēšanas metodes I/O holedohogrāfija I/O USS Duplex I/O endoskopiskā holedohoskopija +/-
- 12. 12 Terapija Konservatīvā terapija nav efektīva Absolūtas indikācijas operatīajai terapijai Iespēja veikt i/o radiologisko izmeklēšanu BDA modo Kasai BDA ar ţ.p. BDA ar intrahepātiskiem ţultsvadiem Aknu transplantācija
- 13. 13 Dif.diagnoze Alagille sindroms Caroli sindroms AD, 1/100,000 AR KVS, CNS, hepatobiliārie traucējumi Aknu fibroze Ţ.v. paplašināšanas Mukoviscidoze Herpes simplex Rubella CMV Syphilis Duodena atrēzija Toxoplasmosis
- 14. 14 Izmantotie datu avoti University of California, San Francisco, database, online 01/05/13 http://pedsurg.ucsf.edu/conditions-treatments/biliary-atresia.aspx John Hopkins Childrens` center, Baltimore, database, online 01/05/13 http://www.hopkinschildrens.org/biliary-atresia.aspx Pediatric Biliary Atresia Differential Diagnoses , Medscape database, online 01/05/13 http://emedicine.medscape.com/article/927029differential