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Laparoscopic Release of Celiac Artery Compression
Laparoscopic Release of Celiac Artery Compression Doctor 16,957 Views • 2 years ago

J Vasc Surg. 2009 Jul;50(1):134-9. Celiac artery compression syndrome managed by laparoscopy. Baccari P, Civilini E, Dordoni L, Melissano G, Nicoletti R, Chiesa R. Department of General Surgery, Scientific Institute San Raffaele University Hospital, Milan, Italy. paolo.baccari@hsr.it Abstr...

act OBJECTIVE: Celiac artery compression syndrome (CACS) is an unusual condition caused by abnormally low insertion of the median fibrous arcuate ligament and muscular diaphragmatic fiber resulting in luminal narrowing of the celiac trunk. Surgical treatment is the release of the extrinsic compression by division of the median arcuate ligament overlying the celiac axis and skeletonization of the aorta and celiac trunk. The laparoscopic approach has been recently reported for single cases. Percutaneous transluminal angioplasty (PTA) and stenting of the CA alone, before or after the surgical relief of external compression to the celiac axis, has also been used. We report our 7-year experience with the laparoscopic management of CACS caused by the median arcuate ligament. METHODS: Between July 2001 and May 2008, 16 patients (5 men; mean age, 52 years) were treated. Diagnosis was made by duplex ultrasound scan and angiogram (computed tomography [CT] or magnetic resonance). The mean body mass index of the patients was 21.2 kg/m(2). One patient underwent laparoscopic surgery after failure of PTA and stenting of the CA, and two patients after a stenting attempt failed. RESULTS: All procedural steps were laparoscopically completed, and the celiac trunk was skeletonized. The laparoscopic procedures lasted a mean of 90 minutes. Two cases were converted to open surgery for bleeding at the end of the operation when high energies were used. The postoperative course was uneventful. Mean postoperative hospital stay was 3 days. On follow-up, 14 patients remained asymptomatic, with postoperative CT angiogram showing no residual stenosis of the celiac trunk. One patient had restenosis and underwent aortoceliac artery bypass grafting after 3 months. Another patient had PTA and stenting 2 months after laparoscopic operation. All patients reported complete resolution of symptoms at a mean follow-up of 28.3 months. CONCLUSIONS: The laparoscopic approach to CACS appears to be feasible, safe, and successful, if performed by experienced laparoscopic surgeons. PTA and stenting resulted in a valid complementary procedure only when performed after the release of the extrinsic compression on the CA. Additional patients with longer follow-up are needed.

How CPAP works
How CPAP works samer kareem 14,604 Views • 2 years ago

CPAP, or continuous positive airway pressure, is a treatment that uses mild air pressure to keep the airways open. CPAP typically is used by people who have breathing problems, such as sleep apnea. CPAP also may be used to treat preterm infants whose lungs have not fully developed.

Professional Breast Exam
Professional Breast Exam JanMalkoske 35,271 Views • 2 years ago

Professional Breast Exam

Wernicke-Korsakoff Syndrome
Wernicke-Korsakoff Syndrome samer kareem 5,075 Views • 2 years ago

-Korsakoff's syndrome is a common and preventable sequel of Wernicke's encephalopathy. Thiamine, if given during the stage of Wernicke's encephalopathy, can prevent the onset of Korsakoff's psychosis. The administration of glucose prior to thiamine can precipitate Korsakoff's syndrome, as seen in this case. In such patients, brain MRI frequently shows abnormal enhancement of the mammillary bodies & thallamus

Revision knee Replacement part 1
Revision knee Replacement part 1 A.K. Venkatachalam 20,993 Views • 2 years ago

Revision knee replacement is peformed by Dr.Venkatachalam for lack of mobility. Infection. aseptic loosening are frequent causes requiring a revision. Madras Joint replacement center performs primary and revision knee replacements in a super specialty hospital in Chennai, India. Dr.Venkatachalam, the chief orthopedic surgeon is UK board certified.

Neck and Cardiac Exam
Neck and Cardiac Exam Surgeon 23,362 Views • 2 years ago

Neck and Cardiac Exam

Henoch--Schönlein Purpura
Henoch--Schönlein Purpura samer kareem 22,480 Views • 2 years ago

An antecedent upper respiratory infection is present in 50% of patients. Abdominal pain is a presenting symptom in 1 0-15% of patients. The skin lesions are symmetric, involve dependent parts of the body, and classically progress from an erythematous, macular rash to papular purpura. The joints and kidneys are also commonly involved

Heart Valve Surgery Animation
Heart Valve Surgery Animation Alicia Berger 33,783 Views • 2 years ago

An animation illustrating valvular heart surgery

Renal biopsy
Renal biopsy samer kareem 8,208 Views • 2 years ago

A renal biopsy is a procedure used to extract kidney tissue for laboratory analysis. The word “renal” describes the kidneys. A renal biopsy is also called a kidney biopsy. The test helps your doctor identify the type of kidney disease you have, how severe it is, and the best treatment for it.

CHest x-ray interpretation --Right middle lobe collapse
CHest x-ray interpretation --Right middle lobe collapse academyo 11,544 Views • 2 years ago

The video will describe features of right middle lobe collapse on a chest x-ray. Please see my website for discalimer.

How To Apply Contact Lenses
How To Apply Contact Lenses samer kareem 8,941 Views • 2 years ago

How To Apply Contact Lenses

Examination of the Lower Limbs
Examination of the Lower Limbs Doctor 77,959 Views • 2 years ago

Medical Examination of the Lower Limbs

Tracheotomy Procedure for Airway- 3D Medical Animation
Tracheotomy Procedure for Airway- 3D Medical Animation Scott 16,575 Views • 2 years ago

A tracheotomy or a tracheostomy: is simply an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube and is commonly done in an operating room under general anesthesia. A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. Breathing is done through the tracheostomy tube rather than through the nose and mouth. The term “tracheotomy” refers to the incision into the trachea (windpipe) that forms a temporary or permanent opening, which is called a “tracheostomy,” however; the terms are sometimes used interchangeably.

Is a New Treatment for Diabetes Near?
Is a New Treatment for Diabetes Near? samer kareem 1,995 Views • 2 years ago

A new Harvard study claims a breakthrough that could lead to a new treatment of Type 1 diabetes. WSJ's Ron Winslow explains what it means on Lunch Break. Photo: Getty

Ultrasound Guided Lumbar Puncture Procedure
Ultrasound Guided Lumbar Puncture Procedure samer kareem 3,073 Views • 2 years ago

Lumbar puncture is a common emergency department procedure used to obtain information about the cerebrospinal fluid (CSF) for diagnostic and, less commonly, therapeutic reasons. Please refer to the full article on Lumbar Puncture for more details on the lumbar puncture procedure. Lumbar puncture is typically performed via “blind” surface landmark guidance. The surface landmark technique is reported to be successful in a high percentage of attempted lumbar punctures; however, surface landmark identification of underlying structures has been shown to be accurate only 30% of the time. [1] Unsuccessful identification of proper landmarks often leads to increased difficulty in obtaining CSF, if the procedure is performed, and a higher rate of complications. Few alternatives are available in these cases. If available, fluoroscopic-guided lumbar puncture may be performed. If not, treatment is sometimes initiated empirically without obtaining CSF. Disadvantages of using fluoroscopy include limited availability or necessary transport of the patient outside of the emergency department, inability to directly visualize the spinal canal, and inherent radiation exposure

Hypertensive Emergency Treatment
Hypertensive Emergency Treatment samer kareem 5,333 Views • 2 years ago

Hypertensive urgency must be distinguished from hypertensive emergency. Urgency is defined as severely elevated blood pressure (ie, systolic >220 mm Hg or diastolic >120 mm Hg) with no evidence of target organ damage.

Loyola Abdomen Examination
Loyola Abdomen Examination Loyola Medicine 21,858 Views • 2 years ago

Medical examination of the abdomen from Loyola University, Chicago

Gastric Bypass Surgery
Gastric Bypass Surgery samer kareem 6,298 Views • 2 years ago

Gastric Bypass Surgery - Maagverkleining - Weight Loss Surgery - WLS

Duodenal Ulcer
Duodenal Ulcer Scott 19,558 Views • 2 years ago

This 40 yr male had upper abdominal pain for 3 months. A video-endoscopic examination of esophagus, stomach and duodenum was performed. A large 2.5x2.5 cm chronic ulcer was detected in the first part (bulb) of duodenum. A gastric biopsy was taken for diagnosis of Helicobacter infection and a rapid urease test done which was positive. He received triple therapy (2 antibiotics and acid suppressive drug for one week) to eradicate Helicobacter pylori infection. Ulcer disease showed rapid clinical and endoscopic healing. Eradication of Helicobacter pylori infection led to permanent ulcer cure.

The Nurse Job
The Nurse Job samer kareem 42,074 Views • 2 years ago

The Nurse Job is very hard

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