جستجوی مقالات مرتبط با کلیدواژه « Laparatomy » در نشریات گروه « پزشکی »

Volvulus of colon is a very rare phenomenon in post cardiac surgery course, and their predicting factor in most patients is unknown. Between colonic volvulus, splenic flexure is the rarest site for torsion in general population. The main symptoms are vague abdominal pain, vomiting and distension. The primary diagnostic images include plain chest x-ray, CT scan and colonoscopy.

We report the case of a 57-year -old opium male addict, who was. Admitted for abdominal pain, nausea, and vomiting five days after off-pump coronary artery bypass surgery (OPCAB). An abdominal x-ray reported a colonic volvulus. Exploratory laparotomy showed acute abdomen resulting from a gangrene of long segment of splenic flexure caused by volvulus.

Gastrointestinal complication such as volvulus is an exceedingly rare complication of OPCAB, despite the absence of anatomic abnormalities only complete colonic malrotation as the result of mega colon and constipation, the main pathogenetic causes. This patient was unique because of careful literature search revealed that this case was the first reported volvulus that has been described so far.

Management of pediatric blunt abdominal trauma in resource-restricted settings requires precise clinical expertise. In this study, we reviewed pediatric patients who were suspected to have blunt abdominal trauma in a level III trauma center in Iran.
In a cross-sectional study, 66 injured children were studied from October 01, 2014 to October 01, 2015 in Nikshahr, Sistan-va-Balouchestan, Iran. Patient characteristics, type of trauma, initial evaluation and final decisions were analyzed.
Mean age was 8.2 ± 13.3 years. Thirty five patients (53%) were boys and 31 patients (47%) were girls. Focused Assessment with Sonography for Trauma (FAST) was done for all patients. Diagnostic Peritoneal Lavage (DPL) was done on five patients (7.6%). Laparatomy was conducted on seven patients (10.6%). Ten patients (15.2%) were referred to a higher level trauma center. There were three mortalities (4.5%). Positive FAST was associated with hemodynamic instability (p Computed tomography and intensive care unit may be unavailable in resource restricted settings with level III and IV trauma centers. However, physical examination, FAST and DPL are useful diagnostic tools for assessment of injured children with blunt abdominal trauma.

To determine the epidemiological, clinical, laboratory characteristics as well as outcome of 411 patients with bowel obstruction in Southern Iran. This was a cross-sectional study being performed in Shahid Faghihi hospital of Shiraz between 2006 and 2012. We reviewed the medical charts of the 411 patients with initial diagnosis of bowel obstruction who were admitted to our center during the study period. The patients’ demographic, clinical and laboratory findings as well as their management and outcome was recorded in data gathering forms. The data were then analyzed according to the outcome and clinical characteristics. Among the 411 patients with initial diagnosis of bowel obstruction, 253 (61.5%) were men and 158 (38.5%) were women. The mean age of the patients was 48.2±19.7 years. Besides, 73.6% were observed and 26.4% were operated. Those who were operated had those who underwent operation had significantly lower frequency of obstipation (28.1% vs. 71.9%; p=0.045) and abdominal distention (32.3% vs. 67.7%; p=0.007). Intraoperative findings included adhesion band formation in 50 (48.1%), mass 18 (17.3%), and hernia 7 (6.7%). We found that the frequency of malignancy was significantly higher in those who were managed conservatively compared to those undergoing operation (64.3% vs. 35.7%; p=0.042). The mean hospital stay was significantly higher in those who underwent operation (8.1 ±7.5 vs. 2.6±2.2 days; p=0.035). The results of this study demonstrates although some signs and symptoms, such as abdominal pain, vomiting, abdominal tenderness, abdominal distention, and obstipation, were more common among the patients with bowel obstruction, they were not sensitive and specific enough for definite diagnosis. Due to the lack of positive predictive value of clinical signs and symptoms in diagnosis of bowel obstruction, a reasonable and logical modality is needed for bowel obstruction diagnosis with better accuracy.

To detect the prevalence of Meckel''s Diverticulum in children and adults aged 1 day to 90 years old. This is a cross sectional descriptive study of 1000 cases aged 1 day to 90 years old in the surgery wards of two educational hospitals, Mashhad, Iran from 1998 to 2004. The prevalence of Meckel''s diverticulum, age, sex, and chief complain of patient and the site and size of the diverticulum were evaluated. Meckel''s diverticulum was seen in 5.4% of patients. 62% of patients were younger than 2 years and 80% were male. Gastrointestinal and obstructive symptoms were the most common presenting feature of the condition (38%). Meckel’s diverticulum was observed at 40-59 cm distance from the ileosecal valve with 1-1.49cm length and 0.5-0.99 cm width. Meckel’s diverticulum was more common in children younger than 2 years and was presented by GI obstructive signs in most patients.