#surgical peritonitis

[macgyvermedical]

Let's Talk ESRD and Dialysis

Have you thanked your kidneys today? Do you feel grateful when you pee? How about when you eat a little too much potassium or drink a little too much water, do you really enjoy feeling confident that your kidneys will just dispose of the excess?

If so, you probably know the alternative.

About 10% of the world's population has a condition called Chronic Kidney Disease, or CKD. About 2 million of those people are in End Stage Renal Disease (ESRD) and require dialysis or a kidney transplant to live.

Your kidneys are amazing things. They are two organs that sit outside of the sac that hold the rest of the abdominal organs, called the peritoneum. They take in blood from the body, determine the levels of electrolytes, water, and waste products in that blood, and remove the waste products and excess electrolytes and water.

They also have secondary tasks. They monitor the amount of red blood cells in your blood and send out hormones that entice the bone marrow to make more when we're low. They also monitor blood pressure and release hormones that raise that blood pressure when it gets low.

Lots of things can hurt the kidneys. For example, poorly controlled high blood pressure and poorly controlled diabetes are among the top reasons why kidneys fail. Additionally, being dehydrated while engaging in strenuous exercise or taking medications like ibuprofen or naproxen (any NSAIDs) can cause kidney damage.

We measure how well the kidneys are working via the Glomerular Filtration Rate, or GFR. This is a measure of (essentially) how much blood in milliliters the kidneys filter per minute. 90 or higher is normal, while a GFR of 15 or lower is considered ESRD.

So let's say someone has a GFR of less than 15 and the decision is made to start them on dialysis and put them on the kidney transplant list. What options do they have?

Well, they need to figure out if they want to do hemodialysis or peritoneal dialysis.

In hemodialysis, the patient is hooked up to a machine that runs their blood across a special membrane. On the other side of the membrane, a solution called dialysate draws excess water, electrolytes, and waste products from the blood. Hemodialysis is usually done at a dialysis center for 3-5 hours, 3 times per week.

Hemodialysis is better for patients who have either failed home peritoneal dialysis or can't or aren't comfortable with doing the technical part of the job by themself at home. There is also a social component, where dialysis is a chance to meet and interact with other people who are going through the same things they are.

People who undergo hemodialysis have to have some kind of "access", or a way for the blood to come out of their body, go through a machine, and go back into their body. For some people, this is a dialysis catheter that is inserted into the person's chest and looks like this:

It can also be a fistula. A fistula is the surgical connection between a vein and an artery in the arm or leg. Over time, this connection becomes large and rubbery, and each time dialysis is done, two needles (one to remove blood, and one to return it) are placed in the fistula. A fistula often looks like this:

In peritoneal dialysis, the patient instills the dialysate directly into the sac that holds their abdominal organs. The sac itself acts as the membrane, and dialysate draws the electrolytes, water, and waste directly through the sac wall. They then wait a certain number of hours, and drain the dialysate. This can be done manually by the patient during the day, or at night while the patient sleeps with a machine called an automatic cycler. Usually peritoneal dialysis is done every day, with 2-4 cycles of 4 hours per cycle.

People using peritoneal dialysis also need a form of access, but instead of it being to their blood stream, it is to their peritoneum. Here's what that looks like:

The catheter is placed surgically into the peritoneum, and stays there all the time, even in between dialysis sessions.

Someone using peritoneal dialysis has to be very careful when they are accessing their dialysis catheter. This is because the biggest problem with peritoneal dialysis is the risk of a life threatening infection called peritonitis. Someone who gets peritonitis too many times may need to switch to hemodialysis.

Here is what a manual exchange looks ilke:

Someone may choose to do peritoneal dialysis over hemodialysis because it affords more freedom to keep a job or do daily tasks like keeping house. People who do PD also don't have to find rides to the dialysis center. However, they do have to take on more of the responsibility for making sure they do treatments correctly and be able to keep accurate records of the treatments they give themselves. Peritoneal dialysis also tends to be less taxing on the body, and have fewer side effects than hemodialysis when done correctly.

[love-bugsy]

the worst thing about love is… | jason todd (chapter 1)

you’re just trying to get through your surgical residency, but this masked vigilante keeps showing up half-dead on your fire escape and reminding you of your dead best friend. oh well, at least he's cute.

tw: stitches, mentions of blood and injuries, swearing, completely ooc Jason but he’s like my own lil character now and I’m protective, very inaccurate medical terminology and procedure lol

only jerks steal other people's writing (just don't repost, mate)

There’s a dead man on your fire escape.

Well. He’s not actually dead, but his pulse is weak when you drag him into your living room, out of the relentless Gotham rain. Pulling your hand away from under his mask, you crouch down, peeling off the worn leather jacket around his shoulders and unbuckling his pauldrons. You feel around his back, brows furrowed. You can’t feel anything through the padding in his rain soaked shirt.

Hands wandering down to where his front is flat on the floor, you press down on his side, eyes widening when your fingers come back slick with blood. You go into autopilot, flipping him onto his back and yanking up his compression shirt. You might’ve gasped at the knife wound if you weren’t working on instinct. It’s bad. 

Shoving away the doubt clawing at the base of your skull, you steady your trembling hands. You’ve been trained for this. 

Don’t feel, just do.

The cut is long and serrated, and deep as all hell. It slices through the middle of a jagged, Y-shaped scar that chains over his shoulders like a noose. Jesus. 

It’s like he was stabbed and then dragged across the floor, cutting diagonally across his torso. How is he even still alive? Your hands move faster than you can think, completing an internal checklist as you go.

Breathing? Fast and shallow through his modulator, no obstructions. Bleeding? Applied tourniquet to epigastric region - transfusion isn’t even an option… Your brain works overtime, sifting through diagnostics lectures - penetrating abdominal trauma, debrided of devitalised tissue, no visible debris… You trace the edges of the wound looking for inflammation or fluid buildup; signs of peritonitis, but the weapon seems to have missed any internal organs. Lucky. Even luckier that he landed on a surgical resident’s fire escape.

Reaching over to the lamp by your couch, you shift it so that it shines directly over his abdomen. A last check of his wound confirms that there are no external indications that you should conduct a laparotomy. You just have to sew him up and hope to god the knife didn’t puncture anything internal.

You keep a hand planted firmly over his tourniquet, applying constant pressure, reaching for your backpack. Dragging it over, you use your teeth to open your suture kit and your free hand to sterilise his cut with Betadine and alcohol, wiping gentle circles outward from the wound. You dip your needle like Achilles in the Styx, hand and all, into the sterilising liquid, tugging a glove on with your teeth. 

You grip the needle driver in your dominant hand, pickups clutched in the other and take a steadying breath. There’s a stillness to the room, quiet save for your heartbeat pounding in your ears. The wound is large - high tension - so… mattress sutures… horizontal so the tension is spread over the edge of the wound. 

You take your first bite, adrenaline driving your needle into a clean stitch. You reverse it, passing through his cut again, before tying it off with the practised motions of a thousand surgical knots tied on yarn and thread and fraying jeans. You settle back on your knees after the first suture, readying yourself for the stitching to come, and start the next one.

~

Hours later, you haul him onto your couch, sitting him up on the arm rest to take pressure off of his dressed stitches. Frowning deeply at how uncomfortable he looks - even unconscious, you tuck a throw pillow under his scuffed metal mask. 

Leaning close to check his breathing, you hear crackling slow and deep through the helmet’s voice modulator. Bone-deep relief floods your system, a little sigh leaving your mouth involuntarily. Sitting heavily against your coffee table, you press the heels of your hands into your weary eyes. 

He’s stable. For now at least. 

Head bumping against the edge of your couch, you breathe in deeply, fighting the anxiety twisting in your ribcage. The couch smells like rubbing alcohol, stinging your nose so badly your eyes water. It’s followed by something familiar - underneath the heady scent of petrol and metal - like… if you mixed Gotham up into a single smell; rain and smoke and wet pavement. He… he smells like-

“Jay!” 

The faulty fluorescent lights - courtesy of your parent's small family diner - seem to flicker in tandem with your strident yell.

Your best friend looks up at you through a mop of dark hair, collarbones poking out of his thin t-shirt, second-hand leather jacket chucked haphazardly on the other side of the booth. He’s stolen your copy of Jane Eyre, flattened with one hand next to a plate of old fries you’d scrounged for him.

You tug your book from his grasp, tucking your pen into the pocket on your apron. He looks up at you with a mouth full of fries, infuriating confusion written across his face.

“What? You promised I could read it.” You sigh in exasperation.

“When I’m finished! And-” A dramatic gasp rips from your mouth when you examine the book. “Are these- grease stains?” You take the book in both hands, swatting Jason with it.

“What so it’s okay to hit me with a book but not get grease- fuck, jesus, okay, okay!” You raise the book over your shoulder with both hands.

“Do you yield?” His mock-angry expression almost makes you laugh, a hand held up near his face to shield from your attack. There’s a soft twist to his frown, like he’s trying to stop his mouth from pulling into a grin. He raises his hands in surrender, and you relax your hold on the book.

Rookie mistake.

Jason darts forward, faster than you can blink, grasping your waist with both hands and dragging you towards him. He yanks the book from your hands and lets you go, grinning childishly at you with the book in his hands. The cat with the canary.

You throw your hands up in exasperation before planting them on your hips like a disappointed mother. The admonishment on the tip of your tongue turns into a weary sigh when you hear your parents calling for you from the diner kitchen. “Fine. But you actually have to try to not spoil it this time.”

Jason crosses his fingers over his chest, “Scout’s honour, birdie.” 

You try not to flush at the nickname, just like you do every time he says it. Still, you fold like a stack of cards.

(He spoils it the next day.)

~

When you wake two hours later for rounds (at the ass-crack of dawn), he’s already gone. You pad quietly around your kitchen making coffee from day-old grounds, cautious not to disturb the sanctity of the early morning (or the ghost of his presence).

The only evidence of him is alight in the dim light that spills over your kitchen counter and into your living room - the deep indents in your couch and the bloodstains on your carpet… The rain on your wood floors, from the fire escape window you’re sure you didn’t leave open.

hi, hello, uhh this is the first fic I've ever posted so bear with me. if anyone actually sees this, i do apologise for the inaccuracies and lengthy prose. also, this will be a series so stick around if you like slow updates, slowburn and second chances. thanks for reading my rambles.

with love, bugsy

[torturing-characters-101]

what would be the affects of a cut wound to the side of the abdomen, about five inches long, one inch deep, that was left for an hour with the only care to it being pressure applied with a rag?

Depends on if the cut entered the abdominal cavity or just cut through fat and muscle.

If the cut was just through fat and muscle, not much. It would bleed but not life-threateningly, and would need cleaned well and either packed (remote/wilderness setting) or closed surgically (hospital setting). Antibiotics and a tetanus shot would probably be given to prevent infection.

If the cut was into the abdominal cavity (the sac that holds the abdominal organs), the bleeding again wouldn't be life threatening, but now you're talking an actual need for a very specific kind of cleaning and surgery, and probably IV antibiotics to prevent a serious infection called peritonitis.

[killed-by-choice]

“Madame A, 38” (France ~1975)

A woman identified only as “Mme. A” in a medical journal was killed by a legal abortion in France, reported at the end of the year that abortion was legalized essentially on demand. She was six weeks pregnant when she went to an abortionist only identified in the medical journal as “Dr. X.”

Mme. A’s pre-op examination showed no health problems. As a precaution, she was prescribed antibiotics in advance. She was led to believe she was in the hands of an expert, who claimed to have carried out over 1,400 abortions without complications. However, this claim would soon prove to be suspicious given what he failed to recognize.

The aspiration abortion was done in only three minutes with no anesthesia. Nobody noticed even the slightest anomaly and Mme. A was discharged from the abortion facility two hours later. Dr. X. reported that she wasn’t in pain even though she herself said that she was, albeit that the pain wasn’t severe at that point and she wasn’t worried.

Over the next two days, Mme. A’s pain increased. On the third day, she got a referral for a different doctor. This doctor observed her for a few hours and then performed emergency surgery, realizing the condition she was in.

Dr. X. had failed to notice even the slightest anomaly during the abortion or any pain after it, but he had inflicted serious injuries. He had torn a hole through Mme. A’s uterus, then perforated her small intestine through the hole. She was now suffering generalized peritonitis and needed a resection of the small intestine along with drainage for abscesses.

The day after her emergency surgery, Mme. A worsened. She was developing dypsnea and large bilateral hemorrhagic pleural effusions. On the fifth day, she was admitted to the ICU at Antoine-Béclère Hospital. She was under constant intensive care for 15 days, but this was further complicated by pulmonary embolism and digestive bleeding from stress ulcers. Just as her condition seemed to be somewhat under control, she suffered a recurrence of the pulmonary embolism. She died on her 16th day in Intensive Care, leaving a 10-year-old and a 9-year-old without their mother.

The medical journal that documented Mme. A’s death labeled her course of complications as “unfortunately classic” when operating on a patient with peritonitis, partial evisceration, pulmonary embolism, abscesses and internal bleeding. It was noted in the review of her case that suction abortion is a surgical operation and should not be treated as trivial. It was recommended that abortion clients be monitored in a real hospital setting for 2 to 3 days afterwards. The surgery department of the hospital submitting Mme. A’s case stated that, “the official and even legislative publicity of the safety of the method also has a certain responsibility in our eyes.” Even though it was now legal and done by a self-proclaimed “expert,” abortion was still not a safe operation or one to be taken lightly.

[sarajcsmicasereports]

A Rare Metachronous Colonic Volvulus by Philip Ade Ekhaiyeme in Journal of Clinical Case Reports MedicaI Images and Health Sciences 

Abstract

Introduction: Colonic volvulus is a common cause of large bowel obstruction with the sigmoid colon most commonly affected. Volvulus of the transverse colon is an uncommon occurrence. Rarer still is a transverse colon volvulus developing after surgery for a sigmoid colon volvulus. Early diagnosis is critical as delay in detection and intervention is associated with the risk of complications – perforation, peritonitis, and death.

We discuss the case of an 86-year-old man presenting with features of large bowel obstruction 14 months following a sigmoid colectomy for a sigmoid colon volvulus. An erect abdominal radiograph showed massively dilated large bowel loops with multiple air-fluid levels, a gasless pelvis, and no free air under the diaphragm. Obstruction did not resolve with initial non-operative measures necessitating surgical intervention. Following resuscitation, he had an exploratory laparotomy with findings of a transverse colon volvulus twisted 5400 in an anticlockwise manner with a perforation on the descending colon for which he had a left hemicolectomy. The postoperative course was uneventful.

Conclusion: A metachronous transverse colonic volvulus is uncommon. Pre-operative diagnosis is challenging as there are no defining radiographic features compared to the volvulus of the sigmoid colon with the classical omega sign. Most cases are diagnosed intra-operatively. Bowel resection and anastomosis in a single stage is a safe option.

INTRODUCTION

Colonic volvulus is the torsion of the colon on its mesentery, with the sigmoid colon the most affected (75%).[1,2] There are a few cases of volvulus reoccurring in the same patient after treatment for an initial one.[3] We share our experience in the management of a patient with metachronous colonic volvulus.

Case Presentation

An 86-year-old man, with no known comorbidity, presented with a five-day history of colicky abdominal pain, worsening distension, and associated constipation which progressed to obstipation. The pain worsened significantly but with no associated vomiting. His last bowel movement was 4 days before presenting to the hospital. There was no history of fever, jaundice, early satiety, spurious diarrhea, the passage of pellet-like stools, or weight loss.

At admission, he was pale, not dehydrated, and tachycardic with a pulse rate of 120 per minute. His blood pressure was consistently high from presentation although he was not previously diagnosed as hypertensive. His abdomen was markedly distended with a midline longitudinal scar and hypoactive bowel sounds. There was no rebound tenderness. A digital rectal examination revealed scanty hard feces.

Past medical history showed he had a similar presentation fourteen months prior, with complaints of recurrent, worsening abdominal distension over a preceding 6 months period with associated pain, anorexia, and weight loss. Abdominal radiograph and ultrasound scan confirmed abdominal distension with volvulus.

The full blood count revealed neutropenia and eosinophilia. Further workup tests for surgery were all within normal limits, including the electrolytes, urinalysis, and clotting profile. A plain abdominal x-ray revealed the classic omega sign (shown in Fig. 1). He had an exploratory laparotomy and the findings were markedly dilated sigmoid colon rotated about 2700 anticlockwise along its mesentery and it appeared pink and normal and contained hard feces (shown in Fig. 2). The caecum, ascending colon and transverse colon were noted to be mildly dilated. He had a one-stage sigmoidectomy with end-to-end anastomosis

With the current admission, a provisional diagnosis of adhesive bowel obstruction was made. Resuscitation was commenced with a nasogastric tube passed for immediate decompression. Evaluations were done to rule out a possibility of a second volvulus in this patient or Ogilvie syndrome as a second alternative. He was rehydrated with intravenous fluids and had a trial of enema done with minimal improvement.

He had a normal white cell count with a neutrophil predominance of 80.6% and a hematocrit value of 39.3%. Biochemical parameters were essentially normal except for a potassium level of 3.0mmol/L which was corrected before surgery. Viral markers were all negative and the clotting profile was not deranged. Urinalysis showed proteinuria, ketonuria, and haematuria. He had an erect abdominal radiograph done which showed multiple air-fluid levels and a gasless pelvis and a supine view showed massively dilated (>10cm) bowel loops peripherally located, with haustra markings (shown in Fig. 3).

Carcinoembryonic antigen was not elevated. Glycated hemoglobin was done after random plasma glucose was noted to be elevated. This was normal -5.9%. There were no abnormalities on the plain chest radiograph. His ejection fraction on echocardiography was 67%.

He underwent an exploratory laparotomy after the correction of hypokalaemia. Intraoperatively, findings included a massively dilated transverse colon that was twisted 5400 in the anticlockwise direction, perforation in the descending colon with spillage of intestinal contents (shown in Fig. 4). The bowel was viable and a left hemicolectomy was done with one-layered end-to-end anastomosis using 2-0 VicrylTM.

Following surgery, the clinical course was uneventful and he was discharged home 8 days after surgery.

Discussion

Colonic volvulus is the third leading cause of large bowel obstruction. [1] The sigmoid colon is the most affected site. [2] Though relatively uncommon, cases of recurrence of a colonic volvulus have been reported, particularly among younger age groups. [3,4]

Synchronous colonic volvulus is when different segments of the colon are affected simultaneously[5,6]. Few cases have been reported. [7,8,9] Metachronous colonic volvulus affects another segment of the colon at least six months after surgical resection of the previously affected segment of the colon in the same patient. Faranisi reported a similar presentation in a 28-year-old man who presented 3 years apart, with a transverse colon following the occurrence of sigmoid volvulus.[10]

The major risk factor in our patient was a long mesentery. Similarly, in the patient reported by Faranisi, the transverse colon also had a long mesentery. Besides, his ascending and descending colons were notably very mobile – described by the author to be ‘almost as if they had a mesentery’.[10] Both the congenital failure of the right and left colons to be fixed retroperitoneally and his long transverse Meso colon were thought to be probable causative factors. [10]

Several surgical options might be considered in the management of a metachronous volvulus. The patient described here had a surgical decompression at the initial facility where he received care before subsequent sigmoidectomy at his first presentation at our facility and left hemicolectomy after his second presentation

The management of colonic volvulus depends on the clinical status of the patient.[10] The decision to do a left hemicolectomy following representation with a transverse volvulus, in this case, was because of the patient’s age and the need to reduce the risk of short bowel syndrome.

An initial attempt at non-operative treatment might be unsuccessful. The patient presented had a surgical decompression which failed. Several authors also report failed attempts at non-operative management. As such, the definitive treatment of metachronous volvulus should always be surgical and one-staged. [11] Non-operative treatment should not be considered beyond the emergency.

Conclusion

A metachronous colonic volvulus is a rare form of colonic volvulus. Operative treatment offers the best outcomes.

Conflict of Interest : The authors have no conflicts of interest to declare.

Funding Sources: No funding was sought for this study

Author Contributions:

Dr. P. A Ekhaiyeme: Conceptualization, care of patient and writing.

Dr. N. A Olagunju: Care of patient, writing and review.

Dr. O. A Ajagbe: Care of patient and review.

Dr. O. J Bello: Care of patient and writing.

Dr. P. H Yatu: Care of patient.

Dr. O. O Afuwape: Review.

Prof. D. O Irabor: Care of patient, supervision, review and resource.

[jcsmicasereports]

 Transcatheter arterial Embolization of the common hepatic artery for pseudoaneurysm after a laparoscopic-assisted pancreaticoduodenectomy: A case report by Yongxiang Li in Journal of Clinical Case Reports Medical Images and Health Sciences

Introduction

Pancreaticoduodenectomy (PD) is the main procedure for some surgeries related to the pancreas. Due to the advance of the surgical technology in recent two decades, mortality decreased considerably [1]. However, the morbidity rate for the major complication after PD remains high [2]. In the various complications, postpancreatectomy hemorrhage (PPH) is a fatal complication, which is linked with 11%−38% of the overall mortalities [3−6]. According to the International Study Group of Pancreatic Surgery [7], late PPH is caused by a ruptured pseudoaneurysm. Once the pseudoaneurysm ruptures, laparotomy and endovascular intervention are the main treatment to be done. Here we report the clinical features, diagnosis, and treatment of a case of massive hemorrhage in the common hepatic artery (CHA) for pseudoaneurysm after PD.

Case report

A 48-year-old male patient underwent a modified Child PD for the malignant tumor of the descending duodenum. The gastroscope and abdominal enhanced computed tomography (CT) in the preoperative examinations are displayed in Fig. 1. The related index and laboratory values of the patients showed no abnormal outcomes. Standard modified Child PD was performed after excluding the surgical contraindications. No adverse events occurred during the operation. Antibiotic prophylaxis was administered in the postoperative treatment. On postoperative day (POD) 2, the patient suffered from fever and abdominal pain. Persistent peritoneal lavage and drainage were conducted to prevent anastomotic leakage. On POD 8, the continuous drainage stopped because of disappearing abdominal pain. On POD 10, the patient had a sudden abdominal pain and showed 50 mL loss of blood from the drain of cholangiojejunostomy. Hemoglobin concentration decreased to 85 g/L, which had dropped by 45 g/L compared to the last inspection. At the same time, the amylase level measured in the intra-abdominal drainage fluid was 1480u/L. In terms of diagnosis, pancreatic fistula and intra-abdominal bleeding were considered. Conservative treatment, including fluid infusion, use of hemostatic agents, and blood transfusion, was used for this patient. Then, the patient’s condition was stabilized gradually. Abdominal CT was performed on the POD 19, which revealed the existence of bloody fluid collection around the perihepatic area (Fig. 2). On POD 21, the patient underwent catheter drainage under the guidance of ultrasonic from the perihepatic area. Abdominal distension of the patients improved. However, on POD 25, the patient abruptly developed melena and hematemesis, and vomited about 300 mL of bloody fluid. A total of 200 mL bright red bloody fluid drained from the abdominal tube. Then, the patient suffered from a shock with hypotension and tachycardia. Hence, Active abdominal bleeding was considered. Urgent Digital Subtraction Angiography (DSA) performed on the basis of a joint decision between the interventional radiologist and a surgeon. DSA revealed a pseudoaneurysm after the rupture of the CHA (Fig. 3a, Video 1). Then, embolization of the hepatic artery with microcoil was performed successfully (Fig. 3b, Video 2). The patient’s blood pressure returned to normal after embolization. And then the patient regained hemodynamic stability and was transferred to the Intensive Care Unit (ICU). The patient was successfully discharged from the hospital on POD 38. There were no obvious abnormalities in the patient’s reexamination after three months.

DSA procedure:

The patient lied supine on the DSA table; a puncture in the right femoral artery was performed after local anesthesia. The 5FRH catheter was placed into the right femoral artery, the catheter head was inserted into the celiac trunk artery for DSA, and the super-selected microcatheter (Terumo Progreat microcatheter, Japan) was inserted into the hepatic artery. After the hepatic artery, its branches were identified by contrast; the embolization microcoil was placed, followed by the injection of the histoacryl (B.Braun Closure Specialities, Germany) into the hepatic artery. Ultimately, the hepatic artery and its branches did not develop again and hence were not visualized under DSA.

Discussion

Commonly, complications develop after PD; there is no doubt that PPH is dangerous and fatal. Furthermore, a ruptured pseudoaneurysm is the most severe and fatal cause of PPH [8]. The formation of the pseudoaneurysm is associated with the damage to the vascular wall. Although adequate lymph node dissection and skeletonization of the vessels in surgery may significantly improve the patient’s prognosis, the dissection and skeletonization make the arterial wall weak and vulnerable, which is susceptible to erosion by trypsin and elastase from the digestive juice [9].

Then, we analyzed the pathogenesis of this case, which may be related to laparoscopic instrument operation. Especially, the dissociation of vessels and dissection of the lymph nodes caused excessive skeletonization, and then the Hem-o-lock ligation damaged the arterial wall, which may lead to the formation of the pseudoaneurysm in the stump of the ligated artery.

In this case, intraperitoneal hemorrhage occurred after surgery, and the measured drainage liquid amylase was 1480u/L; thus, it was considered that the digestive fluid leak caused by the pancreatic fistula, corroded the blood vessels and eventually led to bleeding. After conservative treatment, there is a possibility of hemodynamic instability that would require emergency DSA examination; the formation of a pseudoaneurysm of the CHA and arterial embolism are also considered. Microcoil was chosen given the hemodynamic instability of the patients; while the liver has a double blood supply, a simple embolism is not likely to cause liver ischemia necrosis. Microcoil and histoacryl embolization were chosen given.

A recent meta-analysis revealed that endovascular treatment of a ruptured pseudoaneurysm had low mortality and morbidity and high success rate than surgical intervention [10,11]. endovascular treatment is considered the first choice in the treatment of pseudoaneurysm recently. Endovascular treatment consists of Transcatheter Arterial Embolization （TAE） and stent-graft placement. Coil embolization as a TAE is an effective approach for the treatment of a pseudoaneurysm [12,13].

In this case, we summarized several experiences for the iatrogenic traumatic pseudoaneurysm. First, excessive skeletonization of the blood vessels should be avoided, which leads to the injury of the endangium. In addition, when dealing with the stump of the gastroduodenal artery, the lymph node should be proper to avert excessive skeletonization. Second, compression, avulsion, clamping, or stretching of the skeletonization vessels in the laparoscopic operation increases the risk of bleeding and may cause injury of the endangium. Therefore, accurate vascular localization is the key to a successful operation, and improper operation should be avoided especially when ligating the arteries. Third, when using the Hem-o-lock to ligate the artery, it should be closed slowly, which avoids the shearing action to vessels in the closure process, and damage to the arterial stump. Finally, the vessels and lymph nodes should be skeletonized with laparoscopic instruments by blunt dissection. According to our experience, the skeletonization of the blood vessels tends to be covered with an omental flap to prevent hemorrhage after the PD. Several studies [14,15] revealed that the omental flap or falciform ligament placement over a skeletonization of blood vessels could be an effective measure for the prevention of pseudoaneurysm formation after PD.

In conclusion, this case demonstrated the successful experience for the treatment of delayed PPH by TAE. Endovascular treatment is the first choice for the diagnosis and treatment of a ruptured pseudoaneurysm after PD. Although a stent-graft placement is considered a first-line treatment in the endovascular treatment, coil embolization is a reliable, safe, and effective method particularly when unstable hemodynamics of the patient was observed. In a word, when making the treatment plan, the patient’s condition, presentation, and clinical history should be taken into consideration.

Statements for written informed consent

The author has obtained the patient's handwritten informed consent (pic1, 2).

Acknowledgement

Thanks to Xin Xu, Youliang Wu for guiding the format modification and submission of the magazine.

Conflict of Interest Statement

The authors declare no conflict of interest.

Consent for publication

All authors agree to publish the paper.

Funding Sources

This work was supported by a grant from the National Natural Science Foundation of China (81874063) and Natural Science Foundation of Anhui Province (2008085QH408).

Authors’ Contributions

Lifeng Xu collect all the article data and is responsible for writing the full text. Bo Yang participated in the writing of the article and the modification of the article format. Yongxiang Li provided the ideas for the research and all the funding. All authors read and approved the final manuscript.

Availability of data and materials

The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

[mambasoftwares]

What is omental bursa?

The omental bursa, also known as the lesser peritoneal sac, is an anatomical structure located within the abdominal cavity. It is a potential space that lies posterior to the stomach and extends superiorly towards the diaphragm. The omental bursa is an important structure in the human body, playing a role in the movement and positioning of various organs within the abdominal region.

Anatomically, the omental bursa is formed during embryonic development as a result of the rotation of the stomach. As the stomach rotates, its posterior surface comes into contact with the dorsal wall of the abdominal cavity, forming a double-layered peritoneal fold known as the dorsal mesogastrium. This fold, in turn, creates a space between the posterior surface of the stomach and the dorsal abdominal wall, which is referred to as the omental bursa.

The omental bursa is divided into different compartments by various peritoneal reflections and attachments. These compartments include the lesser sac proper, which lies behind the stomach, and the superior recess, which extends superiorly towards the diaphragm. The bursa communicates with the greater peritoneal cavity through an opening called the epiploic foramen, also known as the foramen of Winslow. This opening allows for the passage of structures such as blood vessels and the bile duct.

The omental bursa has important clinical implications. It serves as a potential space for the accumulation of fluid or infection, which can occur in conditions such as pancreatitis or peritonitis. The presence of the omental bursa also influences the spread of diseases or tumors within the abdomen. For example, in cases of gastric cancer, tumor invasion into the omental bursa can occur, leading to a poorer prognosis.

Surgical procedures involving the omental bursa may be performed for diagnostic or therapeutic purposes. For instance, during laparoscopic surgery, the omental bursa can be accessed to visualize and assess the condition of various abdominal organs. In certain cases, it may be necessary to enter the omental bursa to drain fluid collections, remove abscesses, or address specific pathologies.

In summary, the omental bursa is a potential space located in the abdominal cavity, posterior to the stomach. It plays a significant role in the arrangement and movement of abdominal organs. Understanding its anatomy and clinical implications is crucial for healthcare professionals involved in the diagnosis and treatment of abdominal conditions.

[mcatmemoranda]

Small bowel obstruction (SBO) occurs when the normal flow of intestinal contents is interrupted.

●Initial management – Patients diagnosed with acute SBO should be admitted to the hospital and evaluated by a surgeon. The initial management includes volume resuscitation, correction of metabolic abnormalities, bowel rest, and gastrointestinal decompression (with a nasogastric tube) for those with significant abdominal distension, nausea, or vomiting (algorithm 1).

For most patients with uncomplicated SBO, we suggest not administering prophylactic antibiotics (Grade 2C). However, we administer standard perioperative prophylactic antibiotics to patients with suspected bowel compromise (ie, ischemia, necrosis, or perforation) undergoing operative exploration, depending upon the expected wound classification.

●Definitive management

•Indications for immediate surgery – Patients with clinical (fever, persistent tachycardia, focal or generalized peritonitis) or radiologic signs of bowel compromise (ischemia, necrosis, perforation) require immediate surgical exploration. By convention, timely surgery is generally also offered to patients with SBO caused by one of the surgically correctable causes, except adhesions.

•Patients without an indication for immediate surgery – These patients are managed nonoperatively with serial abdominal examinations and laboratory and/or imaging studies as indicated by clinical parameters. In industrialized nations, adhesive SBO is more prevalent than nonadhesive SBO. In the setting of adhesive SBO, nonoperative management is overall successful in 65 to 80 percent of patients.

For patients with adhesive SBO, we suggest giving a hypertonic water-soluble contrast agent (eg, Gastrografin) as a part of nonoperative treatment (Grade 2C). Limited data suggest that a Gastrografin challenge can accelerate the resolution of SBO and reduce the length of hospital stay. However, there is also evidence to suggest that it does not reduce the need for future surgical intervention. Therapeutic use of Gastrografin has not been studied for nonadhesive SBO, is not effective against postoperative SBO, and may not be safe for pregnant patients.

The optimal duration of nonoperative management is uncertain and largely depends on the patient's clinical status and situation. For most clinically stable patients with SBO, we suggest that nonoperative management not be extended beyond three to five days given the increased morbidity and mortality associated with this approach (Grade 2C). However, there are some clinical scenarios in which prolonging nonoperative management may be appropriate. As an example, those with early postoperative SBO can be managed for a longer period of time (eg, up to six weeks) in the absence of clinical deterioration.

●Nonadhesive SBO – SBO can also be caused by nonadhesive etiologies (eg, inflammatory bowel disease, infection, radiation, malignancy), against which targeted therapies are paramount for the resolution of the bowel obstruction.

[macgyvermedical]

We've all heard of ppl getting sent to the ER by putting questionable things up their ass: but how DO they get that stuff out?

Good question!

It depends on what happened, what it is, where it is, and how much damage it's caused.

In order to answer these questions, they'll first ask the patient, in private, what happened. This is largely in case there was a criminal act that led to the object getting inserted, and be able to provide appropriate care.

They would then ask the patient what the object is- the goal is to determine whether the object is sharp, fragile, or particularly rough, making it more likely the patient was injured during the insertion or during any attempts to remove it before arriving at the ED.

A sharp object in the rectum can cause a potentially life-threatening bowel perforation. This is when the rectum or colon tears, causing potentially severe internal bleeding and the spilling of stool (poop) into the normally sterile abdominal cavity. Untreated, this causes a severe infection called peritonitis that can be life-threatening.

If it is sharp, this could also pose a risk to the medical professional trying to remove it, and may need to be done surgically to prevent harm to the patient and the staff caring for them.

They would then take an x-ray to determine exactly where the object was. If that didn't give enough information, they might also do a CT scan.

The simplest possible scenario is that it is a solid, smooth object lodged low in the rectum, with no sign of perforation or internal bleeding.

If this is the case, removal can usually be done in the ED. First they would have the patient lay on their back and bring their knees up to their chest. Then they would sedate the patient with a benzodiazipine and morphine, which decreases pain and helps relax the muscles around the anus. They would then and attempt to remove the object by inserting a proctoscope (think really big version of the thing a doc uses to look in your ears), finding the object, and then removing it with forceps (think medical salad tongs).

If this is not successful, they may take a flexible tube with a balloon on the end, thread the tube past the object, inflate the balloon, and use that to help pull out the object.

If still that didn't work, they'd try to press on the abdomen to see if they could move the object further towards the anus and try again.

If it takes longer than about 30 minutes, or there are any other complications (perforation, sharp object, object that is too far up, etc...), they would be referred to surgery.

In surgery, the patient is under general anesthesia and paralyzed, which makes it a lot easier to remove the object, and it also allows for a much more controlled removal of a sharp or fragile object. They can also use more advanced scopes which can help find and retrieve objects that are farther up in the rectum or even colon.

[ourhealthcare7]

Common Appendix Problems and How Surgeons Can Help

The appendix, a small tube-shaped organ attached to the large intestine, often flies under the radar—until it causes issues. While its exact function is still debated, it's known to be prone to several problems, the most common of which is appendicitis. This blog explores common appendix issues, symptoms, and how surgeons can address these problems effectively.

Click here for more :Appendix Surgeon In delhi

Understanding Appendicitis

Appendicitis is an inflammation of the appendix and one of the most common abdominal emergencies. It often results from a blockage, which leads to infection and swelling. If left untreated, the appendix can burst, causing peritonitis—a severe, life-threatening infection in the abdominal cavity.

Signs and Symptoms of Appendicitis:

Pain in the Lower Right Abdomen: Usually starts near the belly button and then moves to the lower right side.

Nausea and Vomiting: Often accompanies the pain and may increase with movement.

Fever and Chills: An indication of infection in the body.

Loss of Appetite and Digestive Upset: May include bloating, constipation, or diarrhea.

Other Common Appendix Problems

While appendicitis is the most well-known, other appendix issues may arise, though they are less common. These include:

Appendix Tumors: Both benign and malignant tumors can develop in the appendix. Neuroendocrine tumors are the most common, often detected incidentally during imaging or surgery.

Appendiceal Abscess: This can form if an inflamed appendix leaks slowly, creating a localized pocket of infection that can be painful and require drainage.

Mucocele of the Appendix: This rare condition occurs when mucus accumulates, causing the appendix to swell. It may lead to rupture if untreated.

Diagnosis of Appendix Problems

Doctors use several methods to diagnose appendix issues accurately:

Physical Examination: Checking for tenderness in the lower right abdomen.

Blood Tests: Detect signs of infection, such as a high white blood cell count.

Imaging: CT scans are highly effective in detecting appendicitis or other appendix problems. Ultrasound may also be used, especially for children or pregnant women.

Treatment Options: How Surgeons Can Help

Appendectomy: The most common treatment for appendicitis is the surgical removal of the appendix, known as an appendectomy. This procedure can be performed laparoscopically, using small incisions and a camera, allowing for a quicker recovery.

Antibiotic Therapy: In select cases, especially for mild appendicitis, doctors may use antibiotics alone. This is generally not a permanent solution, as appendicitis can reoccur, but it can be useful for some patients.

Drainage for Abscesses: When an abscess is present, it’s often drained before performing an appendectomy. This may involve inserting a needle through the skin to drain the infected fluid.

Cancer Treatment: If an appendiceal tumor is found, a more extensive surgical procedure may be necessary, sometimes involving partial colon removal. Chemotherapy or other treatments may follow, depending on the cancer type and stage.

Final Thoughts

Prompt attention to appendix pain can prevent serious complications. Whether it’s a straightforward appendectomy or more complex treatment for tumors, surgeons are well-equipped to manage appendix issues effectively. If you experience persistent abdominal pain, it’s essential to consult a healthcare provider to rule out appendicitis or other conditions.

Click For Read Also:Appendix Surgeon In Central delhi

[killed-by-choice]

“Regina Roe,” 23 (USA 1972–1978)

“Regina” had multiple pre-existing risk factors before the legal abortion that took her life. She was obese and had recently suffered PID (pelvic inflammatory disease). In addition, the study that recorded Regina’s death noted that based on the data they were able to collect, Black women like her were over three times more likely to die from a second-trimester surgical abortion than a white woman.

Regina underwent the D&E abortion (colloquially known as a dismemberment abortion) at 13 weeks pregnant in a hospital. In theory, the hospital was supposed to have the equipment to save her life. However, even the resources of the hospital wouldn’t save her once the abortionist perforated her uterus and left parts of her baby and/or the placenta rotting inside of her body.

Because of the uterine perforation and incomplete abortion, Regina developed peritonitis and went into septic shock. The infection and injuries killed her. A “safe and legal” abortion made her oldest child an only child, and then took away their mother.

(Regina Roe is Case 2)

[pharmalliance]

Enhancing Patient Care with Precision: VP Shunt System by PharmAlliance International Labs Private Limited

Introducing the VP Shunt Set: Excellence in Neurosurgical Innovation

PharmAlliance International Labs Private Limited proudly presents the VP Shunt Set, an advanced collection of 32 essential instruments meticulously designed to streamline ventriculoperitoneal (VP) shunt procedures. Developed by our dedicated R&D Department, this set exemplifies our commitment to quality, precision, and innovation, ensuring optimal patient outcomes and surgical efficiency for neurosurgeons worldwide.

Unrivaled Precision and Performance

Our VP Shunt Set offers the highest standards of quality and durability, designed to meet the demanding requirements of neurosurgeons. Every instrument in this set has been crafted for exceptional precision, enhancing performance and supporting the success of VP shunt procedures. Let’s explore the detailed array of instruments included in this revolutionary set.

Comprehensive Instrument List for VP Shunt Procedures

Sulemans Subcutaneous Shunt Passer (Adult and Paeds Sizes) – (Qty: 8)

Specialized passers in adult and pediatric sizes facilitate the precise placement of subcutaneous shunts, ensuring effective fluid drainage and patient comfort.

Hudson Brace-Perforator with 4 Burrs – (Qty: 1)

Enables precise burr hole creation, supporting accurate and efficient shunt placement.

Brain Cannula, Frazier DIA 2mm – (Qty: 1)

Provides controlled ventricular access for precise shunt placement and effective cerebrospinal fluid (CSF) diversion.

Adson Dissector 16cm – (Qty: 2)

Allows gentle dissection and tissue manipulation, improving surgical access and visualization.

Mastoid Retractors (Small, Medium, Large) – (Qty: 3)

These retractors securely hold back tissues, ensuring clear visibility and access to the surgical site.

Peritoneal Trocar Standard – (Qty: 1)

Ensures safe and precise access to the peritoneal cavity, minimizing tissue trauma and reducing the risk of postoperative complications.

Cutting Instruments Set (14 pcs) – (Qty: 1)

A comprehensive set of cutting tools designed for precise dissection and tissue manipulation during VP shunt procedures.

Needle Holder, Mayo-Hegar, Fine Large (26cm) – (Qty: 1)

Provides a secure grip for precise suturing, supporting optimal wound closure.

Artery Forceps, Spencer-Well, Various Sizes – (Qty: 4)

Available in multiple sizes for effective hemostasis and tissue manipulation.

Dissecting Forceps (Plain and Toothed) – (Qty: 2)

Enables controlled tissue dissection, enhancing surgical technique and improving outcomes.

Sponge Holder Forceps, Forester, Straight Serrated (24cm) – (Qty: 1)

Ensures secure handling of surgical sponges, maintaining a sterile and optimal environment.

Kidney Tray 20cm without Lid – (Qty: 1)

Provides a sterile space for surgical instruments and supplies.

Instrument Tray Large (35x25x4cm) – (Qty: 1)

Offers organized space for holding and accessing instruments during surgery.

Bowl (Sponge), Diameter 190mm – (Qty: 1)

Ensures convenient storage and accessibility of sponges.

Suction Nozzles, Frazier (DIA 2mm, 3mm, 4mm) – (Qty: 3)

Facilitates effective removal of fluids and debris, ensuring clear visibility and surgical precision.

Quality and Precision You Can Trust

PharmAlliance International Labs ensures that every instrument in the VP Shunt Set undergoes rigorous quality checks and is manufactured in compliance with strict industry standards, including ISO certifications and FDA approvals. This high standard of quality and precision assures surgeons and patients alike of reliable performance and optimal outcomes.

Key Benefits of the VP Shunt Set

Enhanced Patient Outcomes

With high-quality, precision-crafted tools, the VP Shunt Set helps minimize complications, leading to better patient outcomes.

Improved Surgical Efficiency

Our instruments are designed to reduce surgeon fatigue and improve maneuverability, allowing for greater control during delicate procedures.

Durability and Maintenance

Manufactured from premium stainless steel, our instruments are durable, corrosion-resistant, and easy to sterilize, ensuring longevity and reliability across multiple uses.

Comprehensive Solution for Neurosurgeons

The set provides all the necessary tools for effective and efficient VP shunt procedures, making it a valuable asset in any neurosurgical practice.

Frequently Asked Questions (FAQs)

1. How should I sterilize the instruments? Our VP Shunt instruments can be sterilized using standard autoclaving procedures to ensure they remain safe and effective for each use.

2. What is the warranty period for the VP Shunt Set? We offer a 5-year warranty on all our surgical instruments, covering any manufacturing defects.

3. Are replacement parts available? Yes, PharmAlliance provides replacement parts for all instruments in the set, ensuring they remain in top condition over time.

Partner with Excellence, Elevate Patient Care

PharmAlliance International Labs Private Limited is dedicated to advancing the quality of neurosurgical care through precision instrumentation. With the VP Shunt Set, you can trust in our commitment to excellence, reliability, and patient-focused care, helping you elevate your neurosurgical practice to new standards.

For further inquiries or to place an order, please contact us at:

Email: info@Pharmalliance.pk

Phone: 0333-9261419

WhatsApp: +923018842105

Address: Bungalow No 01, Near Jamia Masjid Sikandar Pura, Peshawar, Pakistan

Set No. 02 — VP Shunt System (32 Pieces)

PharmAlliance: Partner with excellence, and elevate the standards of neurosurgical care with our VP Shunt System—crafted for the highest standards in precision and performance.

[kaizengastrocare]

In this video, Dr. Samrat Jankar, a renowned Surgical Gastroenterologist and Laparoscopic Surgeon at Kaizen Gastro Care, Pune, shares an incredible success story of an 88-year-old patient who underwent laparoscopic surgery for duodenal perforation peritonitis. Despite the challenges posed by advanced age, Dr. Jankar and his team delivered expert care, leading to a smooth recovery and remarkable outcome.https://www.kaizengastrocare.com/

[myrawjcsmicasereports]

Low-grade Appendiceal Mucinous Neoplasm (LAMN): Description of an uncommon entity by Babatope Lanre Awosusi in Journal of Clinical Case Reports Medical Images and Health Sciences

Background: Low-grade appendiceal mucinous neoplasm (LAMN) is an uncommon tumor of the appendix with attendant risk of serious complications.1 It can present with abdominal pain and distention, vomiting, a palpable mass, intestinal obstruction, weight loss, and sometimes intussusception. Other uncommon forms of presentation include hematuria, ureteral obstruction, hydronephrosis, and urinary tract infection.1

Case presentation: A 47-year-old female presented with three days of constant dull right upper and lower quadrant abdominal pain associated with nausea, vomiting, and bloating. She had a similar episode two months prior with intermittent right lower quadrant pain, nausea, and vomiting for two days. There was associated low-grade fever. On examination, she had mild tenderness in the right lower quadrant with no guarding or rebound tenderness. Laboratory investigations showed only leukocytosis. Computed tomography scan of the abdomen done revealed a dilated fluid-filled appendix measuring 1.8 cm in diameter. Laparoscopic appendectomy was done and histopathological examination of the specimen showed features consistent with a low-grade mucinous neoplasm of the appendix with acellular mucin dissecting the muscularis and serosa. Histology did not show peritoneal spread but patient still had post-operative clinical and radiologic follow-up with no adverse event reported.

Conclusion: Low-grade appendiceal mucinous neoplasms are lesions of the appendix that can rupture and lead to pseudomyxoma peritonei with risk of mortality. If it is confined to the appendix, surgical management will suffice with clinical follow-up and imaging if the margins involve acellular mucin or neoplastic epitheli.

[mesolawcenter]

How Do Doctors Test for Mesothelioma? : A Comprehensive Guide

Introduction

Mesothelioma is a rare but aggressive cancer that primarily affects the lining of the lungs, abdomen, or heart. It is often linked to asbestos exposure, making it a critical health concern for those who have worked in industries such as construction, shipbuilding, or asbestos manufacturing. Early diagnosis is vital for better treatment outcomes, yet diagnosing mesothelioma can be challenging due to its nonspecific symptoms. This guide explores how doctors test for mesothelioma, the steps involved in diagnosis, and what patients can expect throughout the process.

Contact Us Now For a Free Consultation - https://mesothelioma-helpline.com/how-do-doctors-test-for-mesothelioma

How Do Doctors Diagnose Mesothelioma?

Doctors use a combination of imaging tests, biopsies, and blood tests to diagnose mesothelioma accurately. Here are the primary methods used:

Medical History and Physical Examination: Doctors begin by taking a detailed medical history, including the patient’s exposure to asbestos. A physical examination may reveal abnormalities such as fluid buildup around the lungs (pleural effusion).

Imaging Tests: These tests help visualize the affected area and detect abnormalities:

X-rays: Initial chest X-rays may show fluid buildup, which can be a sign of mesothelioma.

CT Scans (Computed Tomography): CT scans provide detailed images, allowing doctors to locate and assess the extent of any masses or abnormalities.

MRI (Magnetic Resonance Imaging): MRI scans offer high-resolution images of soft tissues, providing more details about the tumor's size and spread.

PET Scans (Positron Emission Tomography): PET scans can detect cancerous cells by highlighting areas with high metabolic activity, which is characteristic of cancer cells.

What Role Do Blood Tests Play in Mesothelioma Diagnosis?

Blood tests can assist in the diagnosis, but they are not definitive. Doctors may use blood tests to detect specific biomarkers that indicate the presence of mesothelioma:

Mesothelin-Related Protein (SMRP): Elevated levels of SMRP in the blood can suggest mesothelioma, but further tests are needed for confirmation.

Fibulin-3: This protein may also be elevated in mesothelioma patients and can be used to differentiate it from other conditions.

Osteopontin: High levels of osteopontin may indicate mesothelioma, though it is not specific to this cancer alone.

These tests can help support the diagnosis when combined with imaging studies and biopsies.

Why Are Biopsies Essential for Confirming Mesothelioma?

A biopsy is the only way to definitively diagnose mesothelioma. During a biopsy, doctors remove a small sample of tissue from the suspected area for analysis under a microscope. Here are different types of biopsies used:

Needle Biopsy: This involves using a thin needle to extract tissue or fluid from the tumor site. It is less invasive but may not always yield enough tissue for diagnosis.

Thoracoscopy: This procedure allows doctors to visualize the chest cavity and take tissue samples directly from the pleura using a small camera and instruments inserted through a small incision.

Laparoscopy: Similar to a thoracoscopy, a laparoscopy is used to obtain tissue from the abdominal cavity if peritoneal mesothelioma is suspected.

Surgical Biopsy: When less invasive methods do not provide enough information, doctors may perform a surgical biopsy to extract a larger tissue sample.

How Do Pathologists Analyze Biopsy Samples?

After obtaining a biopsy, pathologists examine the tissue samples to determine the presence and type of cancer cells. Here’s what they look for:

Histology: Pathologists study the cell structure to identify mesothelioma cells, which often appear as epithelioid, sarcomatoid, or biphasic (a mix of both).

Immunohistochemistry (IHC): This technique uses antibodies to detect specific proteins that are typically found in mesothelioma cells. IHC helps distinguish mesothelioma from other cancers with similar appearances.

These analyses help determine the type and stage of mesothelioma, guiding the treatment plan.

What Is the Staging Process in Mesothelioma Diagnosis?

Staging describes how far the cancer has spread and helps doctors determine the best treatment options. For mesothelioma, the stages are classified from I to IV:

Stage I: Cancer is localized to one part of the lining of the lung, abdomen, or heart.

Stage II: The tumor has grown and may involve nearby structures.

Stage III: The cancer has spread to nearby lymph nodes or tissues.

Stage IV: Mesothelioma has spread to distant organs or lymph nodes, indicating advanced disease.

Imaging tests like CT and PET scans, combined with biopsy results, help determine the stage of mesothelioma.

What Should Patients Expect During a Mesothelioma Diagnosis Process?

The diagnosis process can be emotionally and physically taxing. Here’s a brief overview of what patients may experience:

Initial Consultations: This includes discussions about symptoms, history of asbestos exposure, and a physical exam.

Referral to Specialists: Patients may be referred to oncologists, pulmonologists, or thoracic surgeons for specialized care.

Diagnostic Testing: Multiple tests, including imaging, blood tests, and biopsies, will be conducted over several appointments.

Waiting for Results: Waiting for biopsy and imaging results can take a few days to a few weeks, depending on the complexity of the analysis.

Receiving a Diagnosis: Once the diagnosis is confirmed, doctors will discuss the type, stage, and potential treatment options with the patient.

Conclusion

Diagnosing mesothelioma is a complex process that involves multiple tests and the expertise of various medical professionals. Early diagnosis is critical for better treatment outcomes, but it often requires a combination of imaging tests, biopsies, and blood analyses to confirm. Understanding these diagnostic methods can help patients and their families navigate the process with greater confidence and clarity. If you or a loved one are experiencing symptoms related to mesothelioma or have a history of asbestos exposure, it’s essential to consult with a healthcare professional promptly.

Frequently Asked Questions (FAQs)

What are the early symptoms of mesothelioma?

Early symptoms include shortness of breath, chest pain, persistent cough, unexplained weight loss, and fatigue. These symptoms can be nonspecific, so a history of asbestos exposure is a key factor in seeking further testing.

How long does it take to diagnose mesothelioma?

The diagnosis process can vary from a few weeks to a couple of months, depending on the time required for testing, obtaining biopsy results, and staging the cancer.

Is mesothelioma curable if caught early?

While there is no definitive cure for mesothelioma, early detection can significantly improve treatment outcomes and potentially extend survival rates through surgery, chemotherapy, and radiation.

Are blood tests alone sufficient for diagnosing mesothelioma?

No, blood tests are not sufficient for diagnosing mesothelioma. They can indicate the possibility of mesothelioma when certain biomarkers are elevated, but imaging and biopsy are needed for a conclusive diagnosis.

What should I do if I think I have been exposed to asbestos?

If you believe you’ve been exposed to asbestos, consult a doctor immediately. They may recommend regular monitoring for symptoms and periodic imaging tests to detect any early signs of mesothelioma.

Can mesothelioma be mistaken for other conditions?

Yes, mesothelioma symptoms can be mistaken for other respiratory or gastrointestinal conditions like pneumonia, lung cancer, or irritable bowel syndrome. That’s why a detailed medical history and multiple diagnostic tests are crucial for an accurate diagnosis.

[aasthadialysishospital]

Hospital in Sri Ganganagar Region

Aastha Hospital: You’re Premier Destination for Nephrology, Cardiology, and General Surgery in Sri Ganganagar

Introduction

Welcome to Aastha Hospital, Sri Ganganagar’s trusted healthcare provider specializing in nephrology, cardiology, and general surgery. Our commitment to high-quality patient care, advanced medical technology, and a compassionate approach sets us apart as a leader in these critical areas of healthcare.

Aastha Kidney and General Hospital is the dream of Sandeep Chauhan and Sonia Chauhan to establish a complete Kidney Care Center in North Rajasthan and South Punjab.

Aastha Kidney and General Hospital was established on 29th July 2001 by   Dr. Sandeep Chauhan and Mrs. Sonia Chauhan .It’s a well renounce Hospital in North Rajasthan and South Punjab for its dedicated services especially related to Kidney Diseases.

Aastha Kidney and General Hospital was the only facility which offered renal transplant other than Jaipur in year 2013 and first to offer Interventional Cardiology in Sri Ganganagar. Dr Sandeep Chauhan’s Aastha has, gained an overwhelming public confidence in offering individualized and holistic care to patients suffering from diseases related to Nephrology, Urology, Gynaecology, Cardiology, General Surgery, Physician, Dental care, Dietitian Facility and Anesthetic.

Specialized Services

At Aastha Hospital, we offer a comprehensive range of services tailored to meet the unique needs of our patients in nephrology, cardiology, and general surgery:

Nephrology

Our nephrology department is dedicated to diagnosing and treating a variety of kidney-related conditions. Our services include:

Dialysis: We provide both hemodialysis and peritoneal dialysis, equipped with the latest technology to ensure patient comfort and safety.

Chronic Kidney Disease Management: Our nephrologists develop personalized care plans to manage chronic kidney disease and prevent progression.

Kidney Stone Treatment: We offer advanced diagnostic tools and treatment options, including extracorporeal shock wave lithotripsy (ESWL) and Ureteroscopy, to effectively manage kidney stones.

Transplant Evaluation and Care: We facilitate kidney transplant evaluations and provide comprehensive post-transplant care to ensure long-term success.

Cardiology

Our cardiology department focuses on the prevention, diagnosis, and treatment of heart-related conditions. Our services include:

Diagnostic Testing: We offer a range of tests, including ECGs, echocardiograms, and stress tests, to assess heart health.

Heart Disease Management: Our cardiologists develop individualized treatment plans for conditions such as hypertension, heart failure, and coronary artery disease.

Interventional Procedures: We perform minimally invasive procedures, including angioplasty and stent placement, to treat blockages and improve heart function.

Cardiac Rehabilitation: Our rehabilitation program helps patients recover after cardiac events, focusing on lifestyle changes, exercise, and education.

General Surgery

Our general surgery department is equipped to handle a wide range of surgical procedures. Our services include:

Minimally Invasive Surgery: We utilize laparoscopic techniques to reduce recovery time and minimize scarring for various abdominal surgeries.

Emergency Surgery: Our surgical team is available 24/7 to handle urgent surgical needs, including appendectomies and trauma surgeries.

Elective Surgery: We provide planned surgeries for conditions such as hernias, gallbladder disease, and colorectal issues, ensuring comprehensive preoperative and postoperative care.

Patient-Centered Approach: Our surgeons work closely with patients to discuss options, risks, and benefits, ensuring informed decision-making.

Advanced Facilities

Aastha Hospital is equipped with modern facilities to support our specialized services:

State-of-the-Art Diagnostic Imaging: We offer advanced imaging services, including CT scans, MRIs, and ultrasounds, to facilitate accurate diagnoses.

In-House Laboratory: Our laboratory provides quick and reliable testing, enabling timely decision-making for patient care.

Operating Theaters: Our surgical suites are equipped with the latest technology to ensure safe and effective surgical procedures.

Comfortable Patient Rooms: We prioritize patient comfort with well-appointed rooms designed to promote healing and well-being.

Patient-Centered Care

At Aastha Hospital, we are committed to providing a patient-centered experience:

Compassionate Support: Our healthcare professionals are dedicated to providing emotional and psychological support to patients and their families throughout the treatment journey.

Education and Empowerment: We believe in empowering patients with knowledge about their conditions and treatment options, helping them make informed choices.

Comprehensive Follow-Up Care: Our team ensures regular follow-ups to monitor recovery and adjust treatment plans as needed, ensuring optimal health outcomes.

Why Choose Aastha Hospital?

Expert Team: Our experienced nephrologists, cardiologists, and surgeons are committed to delivering the highest standard of care in their respective fields.

Community Engagement: Aastha Hospital actively participates in community health initiatives, offering screenings and educational workshops to promote awareness of kidney, heart, and surgical health.

Affordable Care: We strive to make quality healthcare accessible, offering transparent pricing and various payment options to accommodate our patients.

Safety and Hygiene: Our hospital adheres to the highest standards of safety and hygiene, ensuring a safe environment for all patients.

Conclusion

For exceptional healthcare services in nephrology, cardiology, and general surgery, Aastha Hospital is your trusted partner in Sri Ganganagar. Our commitment to quality, advanced medical practices, and patient-centered care ensures you receive the best possible treatment.

To learn more or to schedule an appointment, please contact us today. Your health and well-being are our top priorities!

 Directions

Visit Us 2-D-1, Sukharia Nagar, Sri Ganganagar, Rajasthan 335001, India

 TPA department +91-63755-733030 +91-96602-74000 akghsgnr@gmail.com

Dialysis Hospital in Sri Ganganagar

Kidney Hospital in Sri Ganganagar

Kidney Stone Hospital in Sri Ganganagar

Hospital in Sri Ganganagar