This document summarizes the case of a 29-year-old Asian American male (DS) who presented with severe abdominal pain immediately following an ERCP procedure done for choledocholithiasis. He was diagnosed with probable post-ERCP pancreatitis based on his symptoms and elevated lipase level. He was admitted and his pain improved with IV fluids and pain medication. He underwent a robotic cholecystectomy the next day without complications and was discharged same day.
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
Learn Barium Meal & Follow Through for the beginners from a Radiology Resident.For some image description please go through the text book "David Sutton" because i have described these image during my presentation Verbally..There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: August C...Sean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
• Splenic Rupture
• Obstructive jaundice
• Ovarian Torsion
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
Learn Barium Meal & Follow Through for the beginners from a Radiology Resident.For some image description please go through the text book "David Sutton" because i have described these image during my presentation Verbally..There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: August C...Sean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
• Splenic Rupture
• Obstructive jaundice
• Ovarian Torsion
By Dr. Usama Ragab, Zagazig Faculty of Medicine
PSC incidence ranges from 0.5 to 1.25 cases/100 000.
The prevalence of the disease ranges between six and 20 cases/100 000.
Men are more likely to be affected (70%).
Prevalence of PSC may be increased in first degree relatives of PSC patients
Name Add name hereHIM 2214 Module 6 Medical Record Abstractin.docxgilpinleeanna
Name: Add name here
HIM 2214 Module 6: Medical Record Abstracting
Instructions: In this medical record abstracting assignment you will first need to download and the records (history & physical, surgery consultation, operative report, pathology report and discharge summary) for a patient with digestive system problems. (Recommend reading them in the order listed).
Save your answers to the following related questions in this document and submit them for this module's assignment.
1. Define the terms diverticulosis and diverticulitis.
2. What is the pathophysiology of diverticulitis?
3. What is a hiatal hernia?
4. Describe some of the signs or symptoms a person with a hiatal hernia might have.
5. What is a pulmonary embolus?
6. What was the etiology (cause) of the pulmonary embolus for this patient?
7. What is gastritis?
8. Which problem is likely a contributor to the patient’s Type II diabetes mellitus?
9. What was the purpose of the barium enema?
10. What does the abbreviation HEENT stand for?
11. What is thrombophlebitis?
12. What is a surgical resection?
13. Define anastomosis.
14. What is ferrous gluconate and what is it used to treat?
15. What condition is the drug Darvocet used to treat?
16. What are electrolytes?
17. What is exogenous obesity?
18. Where is the femoral pulse found/taken?
19. Where is the popliteal pulse found/taken?
20. What is hepatosplenomegaly?
21. Which condition(s) is/are the drug Humulin used to treat?
22. What is an adenocarcinoma?
23. Which condition(s) is/are the drug Lanoxin used to treat?
24. What is the purpose of ordering the blood test PTT?
25. What is a colon stricture?
26. What is/are the etiologies associated with colorectal cancer?
27. What is the medical term for gallstones?
28. Which condition(s) is the drug Zantac used to treat?
29. What does the pathology report indicate about the spread of the carcinoma in this patient?
30. What is the etiology of Type II diabetes mellitus?
· Academic arguments are designed to get someone to agree with the author, who may use pathos (emotion), logos (logic and facts) and ethos (authority and expertise) to persuade.
Academic arguments are not about ranting, screaming or otherwise increasing conflict, but in fact are the opposite: They attempt to help the other person understand what the author believes to be right (opinion) based on the evidence presented (authority, logic, facts).
For your topic for your final paper, what kinds of arguments can you develop for your claim (thesis, main idea)?
Health Record Face Sheet
Record Number:
005
Age:
67
Gender:
Male
Length of Stay:
3 days
Service:
Inpatient Hospital Admission
Disposition:
Home
Discharge Summary
Patient is a 67-year-old male. He saw the doctor recently with abdominal pain and constipation. A barium enema showed diverticulosis and perhaps a stricture near the sigmoid and rectal junction. He was scoped by the doctor, who saw a stricture at that point and sa ...
Cholesterolosis of the gall bladder: a surgical dilemmaKETAN VAGHOLKAR
Cholesterolosis of the gall bladder or cholesterol polyps of the gall bladder have always been a contentious issue with respect to the role of prophylactic surgery in view of its asymptomatic state. Symptomatic cholesterol polyps behave similar to gall stones. There is therefore a need for a surgical algorithm to manage these lesions. A case of symptomatic cholesterol polyps of the gall bladder is reported to highlight the clinical presentation, imaging modalities and management strategies. Symptomatic cholesterol polyps of the gall bladder necessitate cholecystectomy. However, surgical intervention for asymptomatic polyps is guided by their size. Increased diameter is highly suspicious of a malignant potential requiring pre-operative staging and radical surgery.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Case Report: ERCP
1. John
Martinelli,
MSIII,
SGUSOM
DATE:
7/7/13
Case
03.
Rotation:
Surgery/Gen
Identifying
Data:
DS
is
a
29-‐year-‐old
Asian
American
male,
English
speaking,
competent
appearing
and
communicative,
who
presented
to
NBIMC’s
surgical
service
on
7/3/13.
He
is
s/p
same
day
EUS
and
ERCP
related
to
a
recent
diagnosis
of
Choledocholithiasis.
He
is
also
a
physician
and
fellow
at
NBIMC.
Chief
Complaint:
Immediately
post-‐ERCP,
DS
described
intolerable
severe
pain
focused
within
the
upper
abdominal
area.
History
of
Present
Illness:
After
a
previous
diagnosis
of
symptomatic
Choledocholithiasis,
DS
presented
on
7/3/13
to
NBIMC’s
Endoscopic
Lab
for
diagnostic
Endoscopic
Ultrasound
(EUS)
and
therapeutic
Endoscopic
Retrograde
Cholangiopancreatography
(ERCP).
Cholecystectomy
was
planned
for
7/5/13.
Findings
revealed
a
small
common
bile
duct
stone
and
sludge
as
well
as
evidence
of
a
large
gallstone.
Biliary
Sphincterotomy
with
stone
extraction
and
stent
placement
was
performed.
Immediately
following
ERCP,
DS
experienced
severe
epigastric
pain
suspicious
of
Iatrogenic
Pancreatitis
related
to
the
procedure.
Diluadid
(Hydromorphone)
was
administered
which
provided
some
relief.
An
emergent
surgical
consult
was
recommended.
Consultant
agreed
with
probable
post-‐ERCP
Pancreatitis
with
the
recommendation
of
NPO,
IVF,
and
Diluadid.
Morning
labs
were
scheduled
and
DS
was
advised
of
the
possibility
of
discharge
the
following
day
or
continued
in-‐patient
monitoring
pending
Cholecystectomy.
Subsequently
on
7/4/13
patient
reported
improved
pain,
however,
he
did
have
significant
nausea
and
vomiting
as
well
as
elevated
Lipase.
It
was
therefore
recommended
he
remain
in-‐hospital
until
Cholecystectomy
the
following
day.
Robotic-‐Assisted
Cholecystectomy
was
performed
on
7/5/13.
DS
tolerated
the
procedure
well
without
complication
and
was
discharged
same
day.
Past
Medical
History:
Unremarkable
systemic
history.
Recent
history
of
Cholecystitis
and
Choledocholithiasis
(as
above).
Negative
surgical
history.
Medications:
None.
Allergies:
NKDA.
Family
History:
Non-‐contributory.
Social
History:
Non-‐smoker,
Non-‐drinker,
No
drug
use.
Physical
Exam
(on
admission):
Vitals:
96.5*,
75,
19,
116/76,
97%
(@
room
air).
GEN:
Alert
and
Oriented.
Appears
in
Pain.
CHEST:
Clear
to
Auscultation
Bilaterally.
CV:
RRR
(-‐)m,r,g
ABD:
Soft,
Non-‐distended,
(-‐)
Guarding,
(-‐)
Rebound,
(+)
TTP
@
Epigastrium.
2.
Labs
(AM
7/4/13):
Na:
143
Cl:
106
BUN:
7
K:
4
Bicarb:
34*
Cr:
0.79
Glucose:
102
Hgb:
13.6
Hct:
41.1
WBC:
5.7
Platelets:
167
Lipase:
336*
ALP:
52
ALT:
169*
AST:
32
Total
Bili:
1.2*
Review
of
Systems
(on
admission):
General:
Neg
Skin:
Neg
EENT:
Neg
Pulmonary:
Neg
Gastrointestinal:
Severe
epigastric
pain
immediately
post-‐ERCP
(as
above).
Genitourinary:
Neg
Musculoskeletal:
Neg
Neurologic:
Neg
Hematologic:
Neg
Endocrine:
Neg
Psychiatric:
Neg
Imaging:
EUS
performed
revealing
small
CBD
stone
and
sludge
with
large
gallstone.
(Images
not
available
on
CERNER).
Discussion:
GS
presented
to
the
NBIMC
surgical
service
on
the
same
day
after
EUS
and
therapeutic
ERCP
with
biliary
sphincterotomy,
stone
extraction,
and
stent
placement
for
recently
diagnosed
symptomatic
Choledocholithiasis.
Immediately
post-‐procedure,
GS
experienced
extraordinary
pain
in
his
epigastric
region
possibly
pathognomonic
of
surgically
triggered
iatrogenic
pancreatitis.
Choledocholithiasis
can
be
described
as
gallstones
that
become
trapped
within
the
common
bile
duct.
These
stones
can
be
considered
primary
or
secondary
depending
on
their
origin
of
formation.
Primary
stones
will
originate
within
the
common
bile
duct
and
are
usually
pigmented
being
composed
of
bilirubin.
Secondary
stones
are
most
common
comprising
95%
of
all
cases
and
normally
originate
in
the
gall
bladder
being
composed
of
cholesterol.
Therefore,
the
medical
history
of
the
patient
may
indicate
possible
etiology.
For
example,
a
patient
with
hemolytic
anemia
may
be
more
susceptible
to
Primary
Choledocholithiasis
from
the
breakdown
of
hemoglobin
to
unconjugated
bilirubin.
In
our
patient
there
was
not
a
contributory
medical
history,
which
leads
us
to
assume
Secondary
Choledocholithiasis.
The
clinical
features
of
Choledocholithiasis
can
be
a
spectrum
from
asymptomatic
to
exquisite
pain
in
the
epigastric
region
and/or
right
upper
quadrant,
as
well
as
jaundice
and
scleral
icterus.
3.
Laboratory
tests
such
as
Total
&
Direct
Bilirubin,
ALP,
ALT,
AST,
RUQ
Ultrasound,
Esophageal
Ultrasound
(EUS),
and
ERCP
can
be
utilized
in
the
diagnosis.
GS
demonstrated
elevated
Total
Bilirubin
and
ALT
consistent
with
the
suspected
diagnosis.
Although
EUS
was
performed,
it
has
been
shown
that
both
EUS
and
RUQ
US
cannot
be
used
to
make
a
definitive
diagnosis
due
to
lack
of
sensitivity
and
specificity.
However,
they
do
add
information
to
the
clinical
picture
to
help
make
the
proper
diagnosis.
ERCP
is
considered
the
gold
standard
in
both
the
diagnosis
and
treatment
of
Choledocholithiasis.
ERCP
in
this
case
proved
the
suspected
diagnosis.
In
certain
cases
whereby
ERCP
fails,
laparoscopic
choledocholithotomy
can
be
performed.
As
suspected
in
DS,
complications
of
ERCP
include
Pancreatitis
occurring
in
approximately
3
to
5
percent
of
individuals.
It
can
be
mild
and
self-‐limiting,
however,
a
longer
hospital
stay
may
be
necessary
depending
on
the
severity
of
symptoms
as
well
as
laboratory
findings.
Because
of
the
significant
pain
experienced
by
DS
as
well
as
his
Lipase
level,
he
was
advised
to
stay
under
supervision
pending
Cholecystectomy.
NPO
was
recommended
as
well
as
appropriate
IVF
and
pain
management.
Although
less
of
a
concern
with
DS,
bleeding
at
the
sphincterotomy
site
can
occur
and
is
also
usually
minimal
and
self-‐limiting.
Aspiration
of
stomach
contents
is
possible.
Intestinal
perforation
is
another
occurrence
that
requires
immediate
surgical
repair.
Infectious
Cholangitis
is
an
additional
rare
complication
that
is
of
minimal
concern
in
this
case
due
to
his
normal
WBC
and
the
acute
nature
of
his
symptoms.
Differential
Diagnosis:
1. s/p
ERCP
Pancreatitis
2. Sphincterotomy
Hemorrhage
3. Aspiration
4. Intestinal
Perforation
5. Cholangitis
Assessment:
Considering
the
pertinent
physical
and
laboratory
findings
which
include
a
Clear
Chest,
CV
RRR,
Normal
WBC’s,
and
Acute
Epigastric
Pain
with
elevated
Lipase,
a
diagnosis
of
Acute
Pancreatitis
secondary
to
ERCP
was
agreed
upon.
Pathophysiology
Iatrogenic
mechanical
insult
of
the
Pancreatic
Ampulla/Duct
triggering
an
inflammatory
response.
Clinical
Features
Mild
to
severe
abdominal
pain,
back
pain,
nausea
+/-‐
vomiting,
and
mild
fever.
Diagnosis
Diagnosis
usually
becomes
apparent
within
a
few
hours
of
the
procedure
presenting
with
clinical
features
as
above.
Elevated
Serum
or
Urinary
Amylase.
Elevated
Serum
Lipase.
Treatment
NPO,
Analgesia,
Nausea
treatment,
IV
Fluids,
and
possible
Nasogastric
Tube
placement
if
unrelieved
nausea/vomiting.
Monitor
Urine
Output.
4.
Risk
Factors
Inappropriate
utilization
of
ERCP,
Sphincter
of
Oddi
Dysfunction,
Lengthy
Procedure,
Surgeon
Inexperience/Errors.
Complications
Prolonged
hospital
stay,
Increased
Morbidity,
Death.
Plan:
DS
to
remain
in-‐patient
with
NPO,
IVF’s,
and
Analgesia
(Ancef).
Robotic-‐Assisted
Cholecystectomy
scheduled
7/5/13
as
prophylaxis
against
future
gallstone
related
disorders.
DS
underwent
Cholecystectomy
as
scheduled
and
tolerated
procedure
well
without
complication.
He
was
discharged
same
day.