This document discusses the optimal workup for diagnosing and evaluating a hiatal hernia. It begins by classifying the four main types of hiatal hernias. For patients with suspected hiatal hernias, the initial workup should include a chest X-ray, upper gastrointestinal series, and endoscopy to determine hernia size and type. Additional tests like high resolution manometry, pH testing, and pulmonary function tests may provide further details. Recurrence rates after hiatal hernia repair are between 5-42%, so symptomatic patients with suspected recurrence also require thorough re-evaluation. The goal of the workup is to accurately diagnose and characterize the hernia to help determine the best surgical strategy.
P388 391SPIGELIAN HERNIA - A COMPLICATION OF LAPAROSCOPIC CHOLECYSTECTOMYPrivet Investments LLC
This article presents a case report of a 65-year-old woman who developed a rare type of abdominal hernia called a Spigelian hernia as a complication of a previous laparoscopic cholecystectomy surgery. Spigelian hernias are rare and occur through a weakness in the abdominal wall muscles. Computed tomography imaging revealed that in this case, the hernia had become incarcerated, with twisted bowel loops trapped within. The patient underwent laparoscopic surgery to repair the hernia. The case demonstrates that while rare, laparoscopic abdominal surgeries can sometimes result in the development of Spigelian hernias post-operatively if trocar incisions are made through the layers of abdominal
This article describes a case of Spigelian hernia that presented as a complication of previous laparoscopic cholecystectomy. Spigelian hernia is a rare type of abdominal wall hernia that occurs through a weakness in the Spigelian aponeurosis. It accounts for 0.12% of abdominal hernias and is most common in those aged 40-70, with a male to female ratio of 1:1.18. The patient, a 65-year-old woman, presented with abdominal pain 5 years after a laparoscopic cholecystectomy. Imaging revealed a hernia containing twisted bowel loops. She underwent laparoscopic hernia repair. Spigelian hernias are difficult
itus inversus totalis is a rare congenital entity characterized by right-to-left transposition of the viscera of the thorax and abdomen. We present the case of a 58-year-old female patient with a history of cholecystectomy 18 years ago, when a diagnosis of situs inversus was made, who presented to the emergency department with obstructive jaundice. With the surgical history and prior knowledge of her condition, an imaging approach and successful endoscopic treatment was performed. Cholelithiasis and situs inversus are a rare combination of entities; this binomial reminds us that in medicine there are no absolute concepts.
The esophageal duplication cyst is a congenital defect of the digestive tract. It has an estimated prevalence of 0.012%, with higher predominance in males. Although it is a common fi nding in children, diagnosis of an esophageal duplication in adults is rare. Following ileal duplication, esophageal is the second most common duplication of the gastrointestinal tract, representing the 10-15% of all gastrointestinal duplication defects. For esophageal duplication, there are two main variants: cystic and tubular, the latter being the least common. They are usually developed during the third to fifth week of gestation due to failure of the vacuolar coalescence. Duplication cysts are commonly located in the distal third of the esophagus.Treatment should always be surgical, even at the asymptomatic stage
of disease, given the possibility of symptom development and complication appearance. Here we present a case of an adult patient presenting with an esophageal duplication cyst with a brief literature review.
Literature review a surgeon's view of recurrent hiatal hernianagandot
This document provides a literature review and recommendations from surgeons on recurrent hiatal hernias. It begins with definitions and classifications of primary and recurrent hiatal hernias. It then discusses the epidemiology, etiology, clinical presentation and diagnosis. Treatment considerations are outlined for acute symptomatic patients requiring urgent surgery versus asymptomatic patients. Surgical techniques are discussed, including reducing hernia contents, excising the sac, releasing adhesions, undoing prior fundoplications if needed, and performing a tension-free hiatal closure with esophageal mobilization. Special populations like obese patients may benefit from bariatric surgery to help control symptoms. The goal is to establish guidelines to help identify and manage this complex surgical condition.
Cysts of the mesentery are among surgical rarities and of varied aetiology with variable presentations and
this has surgical implications in the pediatric age group. They may be derived from the gastrointestinal
tract, the genitourinary system, previous inflammation (pseudocysts) or malignant cystic tumours, but the
commonest cause is generally considered to be a congenital lymphatic cyst. The clinical presentation is not
characteristic and in addition, the preoperative imaging although suggestive is not diagnostic. In most
cases, the diagnosis is confirmed after surgical exploration and removal of the cyst. A case report of a
baby aged 6 months is being reported. Hope that this information will reinforce the diagnostic and
treatment strategy
Abdominal Splenosiscausing Hydronephrosis- A Case Reportsemualkaira
Splenosis is anuncommenprocess ofintra abdominal or extra abdominal splenic tissue seeding, mostly post traumatic.The issueof splenosismostly comesupinpatientspresentingwith suspicious nodules inthe abdominal or chest cavity. It is exactly these patients with a history of blunt abdominal trauma who should be considered as candidates for having splenosis and should be screened with a proper medical history and with the use of novel non invasive imaging modalities thus sparing the patients unnecessary and potentially dangerous procedures.
Abdominal Splenosiscausing Hydronephrosis- A Case Reportsuppubs1pubs1
Splenosis is anuncommenprocess ofintra abdominal or extra abdominal splenic tissue seeding, mostly post traumatic.The issueof splenosismostly comesupinpatientspresentingwith suspicious nodules inthe abdominal or chest cavity. It is exactly these patients with a history of blunt abdominal trauma who should be considered as candidates for having splenosis and should be screened with a proper medical history and with the use of novel non invasive imaging modalities thus sparing the patients unnecessary and potentially dangerous procedures.
P388 391SPIGELIAN HERNIA - A COMPLICATION OF LAPAROSCOPIC CHOLECYSTECTOMYPrivet Investments LLC
This article presents a case report of a 65-year-old woman who developed a rare type of abdominal hernia called a Spigelian hernia as a complication of a previous laparoscopic cholecystectomy surgery. Spigelian hernias are rare and occur through a weakness in the abdominal wall muscles. Computed tomography imaging revealed that in this case, the hernia had become incarcerated, with twisted bowel loops trapped within. The patient underwent laparoscopic surgery to repair the hernia. The case demonstrates that while rare, laparoscopic abdominal surgeries can sometimes result in the development of Spigelian hernias post-operatively if trocar incisions are made through the layers of abdominal
This article describes a case of Spigelian hernia that presented as a complication of previous laparoscopic cholecystectomy. Spigelian hernia is a rare type of abdominal wall hernia that occurs through a weakness in the Spigelian aponeurosis. It accounts for 0.12% of abdominal hernias and is most common in those aged 40-70, with a male to female ratio of 1:1.18. The patient, a 65-year-old woman, presented with abdominal pain 5 years after a laparoscopic cholecystectomy. Imaging revealed a hernia containing twisted bowel loops. She underwent laparoscopic hernia repair. Spigelian hernias are difficult
itus inversus totalis is a rare congenital entity characterized by right-to-left transposition of the viscera of the thorax and abdomen. We present the case of a 58-year-old female patient with a history of cholecystectomy 18 years ago, when a diagnosis of situs inversus was made, who presented to the emergency department with obstructive jaundice. With the surgical history and prior knowledge of her condition, an imaging approach and successful endoscopic treatment was performed. Cholelithiasis and situs inversus are a rare combination of entities; this binomial reminds us that in medicine there are no absolute concepts.
The esophageal duplication cyst is a congenital defect of the digestive tract. It has an estimated prevalence of 0.012%, with higher predominance in males. Although it is a common fi nding in children, diagnosis of an esophageal duplication in adults is rare. Following ileal duplication, esophageal is the second most common duplication of the gastrointestinal tract, representing the 10-15% of all gastrointestinal duplication defects. For esophageal duplication, there are two main variants: cystic and tubular, the latter being the least common. They are usually developed during the third to fifth week of gestation due to failure of the vacuolar coalescence. Duplication cysts are commonly located in the distal third of the esophagus.Treatment should always be surgical, even at the asymptomatic stage
of disease, given the possibility of symptom development and complication appearance. Here we present a case of an adult patient presenting with an esophageal duplication cyst with a brief literature review.
Literature review a surgeon's view of recurrent hiatal hernianagandot
This document provides a literature review and recommendations from surgeons on recurrent hiatal hernias. It begins with definitions and classifications of primary and recurrent hiatal hernias. It then discusses the epidemiology, etiology, clinical presentation and diagnosis. Treatment considerations are outlined for acute symptomatic patients requiring urgent surgery versus asymptomatic patients. Surgical techniques are discussed, including reducing hernia contents, excising the sac, releasing adhesions, undoing prior fundoplications if needed, and performing a tension-free hiatal closure with esophageal mobilization. Special populations like obese patients may benefit from bariatric surgery to help control symptoms. The goal is to establish guidelines to help identify and manage this complex surgical condition.
Cysts of the mesentery are among surgical rarities and of varied aetiology with variable presentations and
this has surgical implications in the pediatric age group. They may be derived from the gastrointestinal
tract, the genitourinary system, previous inflammation (pseudocysts) or malignant cystic tumours, but the
commonest cause is generally considered to be a congenital lymphatic cyst. The clinical presentation is not
characteristic and in addition, the preoperative imaging although suggestive is not diagnostic. In most
cases, the diagnosis is confirmed after surgical exploration and removal of the cyst. A case report of a
baby aged 6 months is being reported. Hope that this information will reinforce the diagnostic and
treatment strategy
Abdominal Splenosiscausing Hydronephrosis- A Case Reportsemualkaira
Splenosis is anuncommenprocess ofintra abdominal or extra abdominal splenic tissue seeding, mostly post traumatic.The issueof splenosismostly comesupinpatientspresentingwith suspicious nodules inthe abdominal or chest cavity. It is exactly these patients with a history of blunt abdominal trauma who should be considered as candidates for having splenosis and should be screened with a proper medical history and with the use of novel non invasive imaging modalities thus sparing the patients unnecessary and potentially dangerous procedures.
Abdominal Splenosiscausing Hydronephrosis- A Case Reportsuppubs1pubs1
Splenosis is anuncommenprocess ofintra abdominal or extra abdominal splenic tissue seeding, mostly post traumatic.The issueof splenosismostly comesupinpatientspresentingwith suspicious nodules inthe abdominal or chest cavity. It is exactly these patients with a history of blunt abdominal trauma who should be considered as candidates for having splenosis and should be screened with a proper medical history and with the use of novel non invasive imaging modalities thus sparing the patients unnecessary and potentially dangerous procedures.
Diagnostic laparoscopy is a minimally invasive surgical
procedure that allows the visual examination of intraabdominal organs in order to detect any pathology. This
procedure allows the direct visual examination of intraabdominal organs including large surface areas of the
liver, gallbladder, spleen, peritoneum, pelvic organs, and
retroperitoneum. Biopsies, aspiration, and cultures can be
obtained, and laparoscopic ultrasound (US) may be used.
Diagnostic laparoscopy is safe and well tolerated and
can be performed in an outpatient or inpatient setting
under general anesthesia (Fig. 1A). There may also be
unique circumstances where office based diagnostic
laparoscopy may be considered under local anesthesia.
These circumstances should include only procedures where
complications and the need for therapeutic procedures
through the same access are extremely unlikely. Manipulation
and biopsy of the viscera is possible through additional ports.
Diagnostic laparoscopy is the most commonly performed
gynecological procedure today. Its greatest advantage is that
it has replaced exploratory laparotomy.
Diagnostic laparoscopy was first introduced in 1901,
when Kelling, performed a peritoneoscopy in a dog and was
called ‘‘celioscopy’’. A Swedish internist named Jacobaeus is
credited with performing the first diagnostic laparoscopy on
human in 1910. He described its application in patients with
ascites and for the early diagnosis of malignant lesions.
In last 10 years, laparoscopy has made a great difference
to the diagnosis of abdominal acute and chronic pain. It
has evolved as an informative and important method of
diagnosing a wide spectrum of both benign and malignant
diseases. Exploratory laparoscopy also allows tissue
biopsy, culture acquisition, and a variety of therapeutic
interventions. Elective diagnostic laparoscopy refers to the
use of the procedure in chronic intra-abdominal disorders.
Emergency diagnostic laparoscopy is performed in patients
presenting with acute abdomen
This document provides background information and summarizes key principles regarding acute appendicitis. It begins by discussing the appendix's role in the digestive system and risk factors for appendicitis. The anatomy and pathophysiology of appendicitis are then described, noting that obstruction of the appendix is the underlying cause. Common presenting symptoms are reviewed, emphasizing that the classic presentation is seen in less than 50% of cases, making diagnosis challenging. Differential diagnoses and the role of laboratory tests, imaging, and clinical assessment in evaluation are also summarized. Throughout, it is stressed that diagnosis relies on integrating multiple factors rather than any single finding.
Diagnostic laparoscopy allows direct visual examination of intra-abdominal organs through minimally invasive surgery. It can detect pathology, obtain biopsies and cultures, and diagnose conditions like appendicitis, diverticulitis, ovarian cysts, and ectopic pregnancy. Key advantages are that it is safe, well-tolerated, and has replaced more invasive exploratory laparotomy. Diagnostic laparoscopy provides accurate diagnosis of conditions presenting with abdominal pain or ascites, correcting clinical diagnoses in some cases. It allows evaluation of conditions affecting female fertility through examination of pelvic organs and tubal patency assessment.
Long term follow up for patients post laparoscopic Heller dor myotomy for ach...Georges Khalifeh
1) The document discusses long term follow up of patients who underwent laparoscopic Heller Dor myotomy for achalasia.
2) It reports that 36 patients underwent the surgery between 2009-2018 and were followed up long term. Only 1 patient developed GERD and 1 had dysphagia treated with dilation, resulting in a low complication rate.
3) The key conclusion is that adding cruroplasty to the myotomy procedure significantly reduces the rate of GERD after surgery compared to myotomy alone.
Aortojejunal Fistula on Healthy Aorta Due to Jejunal DiverticulumJohnJulie1
Aortoenteric Fistula (AEF) is a rare cause of massive gastrointestinal bleeding. Primary AEF are rare and generally the consequence of an aortic aneurysm. The duodenum and esophagus are the main locations of AEF. Diagnosis is difficult and patients are often hemodynamically unstable at the time of management
Aortojejunal Fistula on Healthy Aorta Due to Jejunal DiverticulumJapaneseJournalofGas
Aortoenteric Fistula (AEF) is a rare cause of massive gastrointestinal bleeding. Primary AEF are rare and generally the consequence of an aortic aneurysm. The duodenum and esophagus are the main locations of AEF. Diagnosis is difficult and patients are often hemodynamically unstable at the time of management
Abstract
This case report describes the diagnosis and management of a large mesenteric cyst in a 55 year old lady who presented with abdominal distension & with mass in the left upper quadrant. Mesenteric cysts are rare, benign, abdominal tumors to which <1000 cases have been reported in the literature. While 40% of cases are incidental findings found either through physical examination or imaging, they can cause non-specific abdominal symptoms including pain, altered bowel habits, nausea/vomiting or anorexia. Less commonly, 10% of cases can present with bowel obstruction, volvulus, torsion or shock. In general, the lack of characteristic clinical and radiological features presents as a diagnostic difficulty.
The mainstay in imaging is computerized tomography (CT). CT identifies and helps aid the decision to pursue a laparoscopic or open laparotomy approach, where complete surgical resection is the ultimate goal. In our patient a CT Abdomen & Pelvis showed a large, loculated cystic mass measuring 30cm in cranio-caudal length and 16cm in the transverse and anterior/posterior diameter. While different approaches have been described in the literature to surgically resect such cysts, our approach was largely reflective of size and adherence to surrounding structures in this case. A laparotomy was performed using an upper mid-line 7 cm incision; 4500cc of fluid was aspirated from the cyst which was found to originate from the small bowel mesentery. A complete resection of the multi-loculated cystic sac was done that included the resection of the middle mesenteric vein. The post-operative period was uneventful. The patient was discharged on post-operative day 2. The Histopathology identified the mass as a multi-loculated peritoneal inclusion-type cyst.
Lipoma of the Small Intestine: A Cause for Intussusception in AdultsKETAN VAGHOLKAR
This case report describes a rare case of small intestinal intussusception in a 22-year-old male patient caused by a lipoma. Imaging including ultrasound and CT scan revealed the classic signs of intussusception and identified a likely lipoma as the cause. During surgery, an ileoileocolic intussusception was found and gently reduced, finding a submucosal lipoma as the pathological lead point. The involved intestinal segment containing the lipoma was resected. Histopathological examination confirmed the diagnosis of benign submucosal lipoma. The patient recovered well with no further symptoms.
Information about Obstructed Recto Sigmoid Malignancy by Dr Dhaval Mangukiya.
Details of introduction of obstructed recto sigmoid malignancy, Epidemiology, Pathophysiology, Complications, Early Presentation, Stools, History, Late Presentation, Diagnosis, Imaging, Contrast enema, Screenig, Treatment, Management, Surgical management, Surgical options etc.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
Laparoscopic Excision of Foregut Duplication Cyst of StomachApollo Hospitals
Retroperitoneal gastric duplication cysts lined by ciliated columnar epithelium are extremely rare lesions and its presentation during adulthood is a diagnostic challenge for treating clinicians. This entity often resembles cystic pancreatic neoplasm, retroperitoneal cystic lesions and sometimes as an adrenal cystic neoplasm. Correct diagnosis on the basis of radiological investigation is difficult and histopathologic analysis. We report a case of gastric duplication cyst in a 16year old girl that mimicked as a retroperitoneal /pancreatic /adrenal cystic lesion and was successfully managed by laparoscopy.
“Little Old Ladies Hernia”: A Case Report and Review of Literature_Crimson Pu...CrimsonPublishersAICS
“Little Old Ladies Hernia”: A Case Report and Review
of Literature by Sonali Sethi*, Satyajit Godhi, Pankaj Kumar and Amit Javed in Advancements in Case Studies
Crimson Publishers-A Newborn Presenting With Bilious Vomiting: A Case Report...CrimsonPublishersAICS
Jejunal atresia is a rare cause of small bowel obstruction in newborns, occurring in approximately 1-3 per 10,000 live births. It is caused by in utero vascular insult and presents with abdominal distention and bilious vomiting. Imaging shows dilation of the stomach and proximal small bowel loops ("triple bubble" sign). An upper gastrointestinal study can determine the level of obstruction and rule out malrotation/midgut volvulus, which is a surgical emergency. Surgical resection of the atretic bowel segment and primary anastomosis is the definitive treatment.
Hirschsprung’s disease in adults: Clinical and therapeutic featuresPremier Publishers
Hirschsprung’s disease (HD) is rare in adults and it is thus often undiagnosed or misdiagnosed. Through this series of 12 patients we try to study the clinical characteristics of this pathology, to define its diagnostic clues and to assess the different therapeutic approaches.
Definitive diagnosis is established on histology of specimens from the rectum and colon. The disease involved the rectum and the sigmoid colon in 2 patients and was confined to the rectum, in the 10 others.
Treatment was in all cases surgical consisting of recto-colic resection associated with coloanal anastomosis and a protective right lateral ileostomy.
We conclude that Hirschsprung’s disease is rare in adults but by no means exceptional. It should be considered in young adults with a history of chronic constipation. Diagnosis is first of all clinical. When barium enema appearances are pathognomonic we needn’t resort to histology to confirm the diagnosis. Anorectal manometry does not usually show RAIR. Current primary treatment of HD diagnosed in adults consists mainly of surgical resection.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
1. The document provides a pictorial review of abdominal radiograph findings to aid in interpretation.
2. Key findings discussed include patterns of bowel gas, which can indicate ileus, small bowel obstruction, or large bowel obstruction like sigmoid volvulus.
3. Other findings summarized are abdominal organ delineation, pathologic gas, calcifications, implanted devices, and foreign bodies. The review serves as a guide for systematic analysis of abdominal radiographs in the emergency department.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Diagnostic laparoscopy is a minimally invasive surgical
procedure that allows the visual examination of intraabdominal organs in order to detect any pathology. This
procedure allows the direct visual examination of intraabdominal organs including large surface areas of the
liver, gallbladder, spleen, peritoneum, pelvic organs, and
retroperitoneum. Biopsies, aspiration, and cultures can be
obtained, and laparoscopic ultrasound (US) may be used.
Diagnostic laparoscopy is safe and well tolerated and
can be performed in an outpatient or inpatient setting
under general anesthesia (Fig. 1A). There may also be
unique circumstances where office based diagnostic
laparoscopy may be considered under local anesthesia.
These circumstances should include only procedures where
complications and the need for therapeutic procedures
through the same access are extremely unlikely. Manipulation
and biopsy of the viscera is possible through additional ports.
Diagnostic laparoscopy is the most commonly performed
gynecological procedure today. Its greatest advantage is that
it has replaced exploratory laparotomy.
Diagnostic laparoscopy was first introduced in 1901,
when Kelling, performed a peritoneoscopy in a dog and was
called ‘‘celioscopy’’. A Swedish internist named Jacobaeus is
credited with performing the first diagnostic laparoscopy on
human in 1910. He described its application in patients with
ascites and for the early diagnosis of malignant lesions.
In last 10 years, laparoscopy has made a great difference
to the diagnosis of abdominal acute and chronic pain. It
has evolved as an informative and important method of
diagnosing a wide spectrum of both benign and malignant
diseases. Exploratory laparoscopy also allows tissue
biopsy, culture acquisition, and a variety of therapeutic
interventions. Elective diagnostic laparoscopy refers to the
use of the procedure in chronic intra-abdominal disorders.
Emergency diagnostic laparoscopy is performed in patients
presenting with acute abdomen
This document provides background information and summarizes key principles regarding acute appendicitis. It begins by discussing the appendix's role in the digestive system and risk factors for appendicitis. The anatomy and pathophysiology of appendicitis are then described, noting that obstruction of the appendix is the underlying cause. Common presenting symptoms are reviewed, emphasizing that the classic presentation is seen in less than 50% of cases, making diagnosis challenging. Differential diagnoses and the role of laboratory tests, imaging, and clinical assessment in evaluation are also summarized. Throughout, it is stressed that diagnosis relies on integrating multiple factors rather than any single finding.
Diagnostic laparoscopy allows direct visual examination of intra-abdominal organs through minimally invasive surgery. It can detect pathology, obtain biopsies and cultures, and diagnose conditions like appendicitis, diverticulitis, ovarian cysts, and ectopic pregnancy. Key advantages are that it is safe, well-tolerated, and has replaced more invasive exploratory laparotomy. Diagnostic laparoscopy provides accurate diagnosis of conditions presenting with abdominal pain or ascites, correcting clinical diagnoses in some cases. It allows evaluation of conditions affecting female fertility through examination of pelvic organs and tubal patency assessment.
Long term follow up for patients post laparoscopic Heller dor myotomy for ach...Georges Khalifeh
1) The document discusses long term follow up of patients who underwent laparoscopic Heller Dor myotomy for achalasia.
2) It reports that 36 patients underwent the surgery between 2009-2018 and were followed up long term. Only 1 patient developed GERD and 1 had dysphagia treated with dilation, resulting in a low complication rate.
3) The key conclusion is that adding cruroplasty to the myotomy procedure significantly reduces the rate of GERD after surgery compared to myotomy alone.
Aortojejunal Fistula on Healthy Aorta Due to Jejunal DiverticulumJohnJulie1
Aortoenteric Fistula (AEF) is a rare cause of massive gastrointestinal bleeding. Primary AEF are rare and generally the consequence of an aortic aneurysm. The duodenum and esophagus are the main locations of AEF. Diagnosis is difficult and patients are often hemodynamically unstable at the time of management
Aortojejunal Fistula on Healthy Aorta Due to Jejunal DiverticulumJapaneseJournalofGas
Aortoenteric Fistula (AEF) is a rare cause of massive gastrointestinal bleeding. Primary AEF are rare and generally the consequence of an aortic aneurysm. The duodenum and esophagus are the main locations of AEF. Diagnosis is difficult and patients are often hemodynamically unstable at the time of management
Abstract
This case report describes the diagnosis and management of a large mesenteric cyst in a 55 year old lady who presented with abdominal distension & with mass in the left upper quadrant. Mesenteric cysts are rare, benign, abdominal tumors to which <1000 cases have been reported in the literature. While 40% of cases are incidental findings found either through physical examination or imaging, they can cause non-specific abdominal symptoms including pain, altered bowel habits, nausea/vomiting or anorexia. Less commonly, 10% of cases can present with bowel obstruction, volvulus, torsion or shock. In general, the lack of characteristic clinical and radiological features presents as a diagnostic difficulty.
The mainstay in imaging is computerized tomography (CT). CT identifies and helps aid the decision to pursue a laparoscopic or open laparotomy approach, where complete surgical resection is the ultimate goal. In our patient a CT Abdomen & Pelvis showed a large, loculated cystic mass measuring 30cm in cranio-caudal length and 16cm in the transverse and anterior/posterior diameter. While different approaches have been described in the literature to surgically resect such cysts, our approach was largely reflective of size and adherence to surrounding structures in this case. A laparotomy was performed using an upper mid-line 7 cm incision; 4500cc of fluid was aspirated from the cyst which was found to originate from the small bowel mesentery. A complete resection of the multi-loculated cystic sac was done that included the resection of the middle mesenteric vein. The post-operative period was uneventful. The patient was discharged on post-operative day 2. The Histopathology identified the mass as a multi-loculated peritoneal inclusion-type cyst.
Lipoma of the Small Intestine: A Cause for Intussusception in AdultsKETAN VAGHOLKAR
This case report describes a rare case of small intestinal intussusception in a 22-year-old male patient caused by a lipoma. Imaging including ultrasound and CT scan revealed the classic signs of intussusception and identified a likely lipoma as the cause. During surgery, an ileoileocolic intussusception was found and gently reduced, finding a submucosal lipoma as the pathological lead point. The involved intestinal segment containing the lipoma was resected. Histopathological examination confirmed the diagnosis of benign submucosal lipoma. The patient recovered well with no further symptoms.
Information about Obstructed Recto Sigmoid Malignancy by Dr Dhaval Mangukiya.
Details of introduction of obstructed recto sigmoid malignancy, Epidemiology, Pathophysiology, Complications, Early Presentation, Stools, History, Late Presentation, Diagnosis, Imaging, Contrast enema, Screenig, Treatment, Management, Surgical management, Surgical options etc.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
Laparoscopic Excision of Foregut Duplication Cyst of StomachApollo Hospitals
Retroperitoneal gastric duplication cysts lined by ciliated columnar epithelium are extremely rare lesions and its presentation during adulthood is a diagnostic challenge for treating clinicians. This entity often resembles cystic pancreatic neoplasm, retroperitoneal cystic lesions and sometimes as an adrenal cystic neoplasm. Correct diagnosis on the basis of radiological investigation is difficult and histopathologic analysis. We report a case of gastric duplication cyst in a 16year old girl that mimicked as a retroperitoneal /pancreatic /adrenal cystic lesion and was successfully managed by laparoscopy.
“Little Old Ladies Hernia”: A Case Report and Review of Literature_Crimson Pu...CrimsonPublishersAICS
“Little Old Ladies Hernia”: A Case Report and Review
of Literature by Sonali Sethi*, Satyajit Godhi, Pankaj Kumar and Amit Javed in Advancements in Case Studies
Crimson Publishers-A Newborn Presenting With Bilious Vomiting: A Case Report...CrimsonPublishersAICS
Jejunal atresia is a rare cause of small bowel obstruction in newborns, occurring in approximately 1-3 per 10,000 live births. It is caused by in utero vascular insult and presents with abdominal distention and bilious vomiting. Imaging shows dilation of the stomach and proximal small bowel loops ("triple bubble" sign). An upper gastrointestinal study can determine the level of obstruction and rule out malrotation/midgut volvulus, which is a surgical emergency. Surgical resection of the atretic bowel segment and primary anastomosis is the definitive treatment.
Hirschsprung’s disease in adults: Clinical and therapeutic featuresPremier Publishers
Hirschsprung’s disease (HD) is rare in adults and it is thus often undiagnosed or misdiagnosed. Through this series of 12 patients we try to study the clinical characteristics of this pathology, to define its diagnostic clues and to assess the different therapeutic approaches.
Definitive diagnosis is established on histology of specimens from the rectum and colon. The disease involved the rectum and the sigmoid colon in 2 patients and was confined to the rectum, in the 10 others.
Treatment was in all cases surgical consisting of recto-colic resection associated with coloanal anastomosis and a protective right lateral ileostomy.
We conclude that Hirschsprung’s disease is rare in adults but by no means exceptional. It should be considered in young adults with a history of chronic constipation. Diagnosis is first of all clinical. When barium enema appearances are pathognomonic we needn’t resort to histology to confirm the diagnosis. Anorectal manometry does not usually show RAIR. Current primary treatment of HD diagnosed in adults consists mainly of surgical resection.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
1. The document provides a pictorial review of abdominal radiograph findings to aid in interpretation.
2. Key findings discussed include patterns of bowel gas, which can indicate ileus, small bowel obstruction, or large bowel obstruction like sigmoid volvulus.
3. Other findings summarized are abdominal organ delineation, pathologic gas, calcifications, implanted devices, and foreign bodies. The review serves as a guide for systematic analysis of abdominal radiographs in the emergency department.
Similar to Optimal workup for a hiatal hernia.pdf (17)
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).