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Videoscopic Assisted Retroperitoneal Debridement for infected necrotizing pancreatitis
Videoscopic Assisted Retroperitoneal Debridement for infected necrotizing pancreatitis Mohamed 32,474 Views • 2 years ago

This is the CT of a 43 year old male patiënt with infected necrotizing pancreatitis that will undergo a VARD procedure; Videoscopic Assisted Retroperitoneal Debridment. Two weeks before this procedure two large bore percutaneous drains were placed in the peripancreatic collection. The patient i...s placed in supine position with the left side 30 degrees elevated. A 5-7 cm subcostal incision is made in the left flank. With help of CT images and by following the percutaneous drain, the subcutaneous tissue and the fascia are dissected and we enter the retroperitoneal peripancreatic collection. First, with a regular suction device any pus encountered is removed. Two long sympathectomy hooks are inserted in order to keep in the incision open. We than insert the zero degree laparoscope. The first necrosis encountered is removed under direct sight with the use of long grasping forceps. Following the percutaneous drain deeper into the cavity, parts of loosely adherent necrotic material are removed. Gently pulling we remove the necrotic tissue. The suction device is helpful in removing any fluid obstructing the view. Complete necrosectomy is not the ultimate aim of this procedure. Only loosely adherent pieces of necrosis are removed thereby keeping the risk of tearing underlying blood vessels to a minimum. In the rare case of extensive bleeding, the retroperitoneal cavity can be easily packed, either awaiting the bleeding to definitely stop or to act as a bridge to angiographic coiling. This patient is now 6 weeks after onset of disease. We always try to postpone surgical intervention, if possible up to 30 days. On the left side of the collection is the percutaneous drain. In this patient the drain had worked well for 2 weeks. When the patient deteriorated again it was decided to perform the VARD procedure. Large pieces of necrotic pancreas can be removed with VARD. This is a big advantage ov VARD over pure endosopic or percutaneous techniques. When all the necrotic tissue is removed we clean the cavity. Two drains are left in situ as a postoperative lavage system. The VARD procedure is performed via a 6 cm incision, which is closed and continuous postoperative lavage started immediately.

Removing a 20-CM Long Loa Loa Worm from the Eye
Removing a 20-CM Long Loa Loa Worm from the Eye Scott 4,399 Views • 2 years ago

Loa loa filariasis (also known as loiasis, loaiasis, Calabar swellings, Fugitive swelling, Tropical swelling and African eyeworm) is a skin and eye disease caused by the nematode worm, loa loa. Humans contract this disease through the bite of a Deer fly or Mango fly (Chrysops spp), the vectors for Loa loa. The adult Loa loa filarial worm migrates throughout the subcutaneous tissues of humans, occasionally crossing into subconjunctival tissues of the eye where it can be easily observed. Loa loa does not normally affect one's vision but can be painful when moving about the eyeball or across the bridge of the nose.The disease can cause red itchy swellings below the skin called "Calabar swellings". The disease is treated with the drug diethylcarbamazine (DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva.

Internal Birth Control
Internal Birth Control Scott 34,751 Views • 2 years ago

Diaphragms, rings, and implants

Liver Metastasis Resection
Liver Metastasis Resection Mohamed 13,673 Views • 2 years ago

Liver Metastasis Resection. A Technique That Makes It Easier. Authors: de Santibañes E, Sánchez Clariá R, Palavecino M, Beskow A, Pekolj J. Background: Liver resection is the only therapeutic option that achieves long-term survival for patients with hepatic metastases. We propose a tech...nique that causes traction and counter traction on the resection area, thus easily exposing the structures to be ligated. Since the parenchyma protrudes like a cork from a bottle we named this procedure “Corkscrew Technique”. Objective: To describe an original surgical technique to resect liver metastases. Technique: We delimite the resection area at 2 cm from the tumor. We place separated stitches, in a radiate way. The needle diameter must allow passing far from the deepest margin of the tumor. The stitches must be tractioned all together to separate the tumor from the normal parenchyma. Material and Methods: Between years 1983 and 2006, we perform 1270 liver resection. We used the corkscrew technique like only procedure in 612 patients whereas in 129 patients we associated it to an anatomic resection. Results: Mortality was 1%. Morbidity was 16% with a reoperation rate of 3%. Conclusions: The Corkscrew Technique is simple and safe, it spares surgical time, avoids blood loss, ensures free tumor margins and it is easy to perform.

Valsalva's maneuver
Valsalva's maneuver samer kareem 18,049 Views • 2 years ago

The Valsalva Maneuver is any attempt to exhale with the mouth and nose closed. Named after the Italian physician and anatomist, Antonio Maria Valsalva (1666-1723), it is also known as Valsalva's Test and Valsalva's Method.

What happens when the immune system goes rogue?
What happens when the immune system goes rogue? samer kareem 1,733 Views • 2 years ago

Baby's Failure to Thrive
Baby's Failure to Thrive samer kareem 1,383 Views • 2 years ago

-Failure to thrive (FTT) is not a diagnosis in itself; rather, it is a term used to describe failure to gain weight in children younger than two years old. Children categorized as FTT weigh less than the 5th percentile for their age; more severe cases involve a slowing of linear growth and head circumference as well. The three causes of FTT are inadequate calorie intake, inadequate calorie absorption, and increased calorie requirements. Newborn infants need 110 kcal/kg/day, while children up to twelve months need 100

Animation of shoulder dislocation and relocation biomechanics
Animation of shoulder dislocation and relocation biomechanics samer kareem 3,633 Views • 2 years ago

This is an animation of the biomechanics involved in relocating a dislocated shoulder.

How to Know If You Are Autoimmune
How to Know If You Are Autoimmune samer kareem 4,107 Views • 2 years ago

Learn a simple way to tell if you might be suffering from an undiagnosed autoimmune condition. Examples of autoimmune conditions include: • alopecia areata

CABG
CABG samer kareem 18,352 Views • 2 years ago

Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). CHD is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries.

Clonidine
Clonidine samer kareem 2,145 Views • 2 years ago

Clonidine lowers blood pressure by decreasing the levels of certain chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily. The Catapres brand of clonidine is used to treat hypertension (high blood pressure). The Kapvay brand is used to treat attention deficit hyperactivity disorder (ADHD). Clonidine is sometimes given with other medications

Astigmatism Animation
Astigmatism Animation DrHouse 14,380 Views • 2 years ago

This animated video explains what is meant by astigmatism, which is a very common problem with the eyes.

Endoscopic Injection of Vocal Cord Mass & Bronchoscopy Without Sedation
Endoscopic Injection of Vocal Cord Mass & Bronchoscopy Without Sedation samer kareem 1,484 Views • 2 years ago

This video demonstrates how bronchoscopy and vocal cord mass injections can be performed under endoscopic guidance in a patient without any sedation. Only topical and local anesthesia is used for patient comfort.

New advice for dialysis patients
New advice for dialysis patients Scott 61 Views • 2 years ago

Dialysis patients need to choose their heart medicine carefully, as Canadian researchers say that some beta blockers are easily removed from the blood during treatment. Also, people who eat a Mediterranean diet may decrease their risk of developing kidney problems. Eboni Williams reports on the day's top health news.

Dysmenorrhea—What You Should Know About Diagnosis and Treatment
Dysmenorrhea—What You Should Know About Diagnosis and Treatment samer kareem 1,251 Views • 2 years ago

Dysmenorrhea, or chronic menstrual pain, is the most common gynecological pain condition, affecting from 45% to 95% of menstruating women. But because it is commonly considered a normal aspect of the menstrual cycle,

Lower Extremity Occlusive Disease
Lower Extremity Occlusive Disease samer kareem 1,291 Views • 2 years ago

Claudication, which is defined as reproducible ischemic muscle pain, is one of the most common manifestations of peripheral arterial occlusive disease (PAOD) caused by atherosclerosis. Claudication occurs during physical activity and is relieved after a short rest. Pain develops because of inadequate blood flow. Examination of a patient with claudication should include a complete lower-extremity evaluation and pulse examination, including measuring segmental pressures. Attempt to palpate pulses from the abdominal aorta to the foot, with auscultation for bruits in the abdominal and pelvic regions. When palpable pulses are not present, a handheld Doppler device may be used to assess circulation.

Hemodialysis Procedure #shorts #dialysis
Hemodialysis Procedure #shorts #dialysis Scott 49 Views • 2 years ago

The objectives of hemodialysis are to extract toxic nitrogenous substances from the blood and to remove excess water. In hemodialysis, the blood, laden with toxins and nitrogenous wastes, is diverted from the patient to a machine, a dialyzer, in which the blood is cleansed and then returned to the patient. Diffusion, osmosis, and ultrafiltration are the principles on which hemodialysis is based.

The toxins and wastes in the blood are removed by diffusion—that is, they move from an area of higher concentration in the blood to an area of lower concentration in the dialysate. The dialysate is a solution made up of all the important electrolytes in their ideal extracellular concentrations.

The electrolyte level in the patient’s blood can be brought
under control by properly adjusting the dialysate bath. The semipermeable membrane impedes the diffusion of large molecules,
such as red blood cells and proteins.

#hemodialysis #dialysis #viral #urinaryinfection #shorts #medical #animation

Fetal Laser Surgery
Fetal Laser Surgery Scott 18,444 Views • 2 years ago

Highlights of a fetal laser surgery for twin-to-twin transfusion syndrome (TTTS) will be shown from Tampa General Hospital

TTTS affects 10 to 15 percent of identical-twin pregnancies and is the result of abnormal blood exchange between identical twins through a common placenta. The larger of the twins, or recipient, is surrounded by too much amniotic fluid and in danger of heart failure as its body tries to pump the overwhelming volume of blood intended for both. The smaller, or donor twin, is encased in a shrinking amniotic sac deprived of blood. Without treatment, both will likely die.

Rubén Quintero, M.D., Medical Director of Maternal Fetal Medicine/Fetal Surgery at Tampa General Hospital and Professor and Director of the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida College of Medicine will narrate the procedure and answer e-mail questions live as taped highlights of the procedure are shown.

Thighplasty after massive weight loss
Thighplasty after massive weight loss samer kareem 22,107 Views • 2 years ago

Thighplasty after massive weight loss

Carotid Stenting.
Carotid Stenting. samer kareem 2,936 Views • 2 years ago

It involves placing a small, expandable tube called a stent in the narrowed artery. This procedure is also called carotid angioplasty and stenting. There are two carotid arteries-one on each side of the neck-that supply blood to the brain. These arteries can be narrowed and damaged by fatty deposits called plaque.

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