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LIS Closed done at 5 O clock position, using Scalpel blade 15. After feeling the groove between internal and external anal sphincter, the blade is passed in and the lower 1/2 of Internal anal sphincter is cut. Remain below dentate line. If anal mucosa is accidently cut suture with 4-0 rapid vicryl. In event of bleeding, pinchcock for 5 minutes.
A central venous catheter (CVC), also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein. Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters). It is used to administer medication or fluids that are unable to be taken by mouth or would harm a smaller peripheral vein, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure.
Chest pain is a frequent complaint of patients seeking urgent medical assistance, and accounts for an estimated 2-4 per cent of all A&E visits in the UK (Becker, 2000). Generally, acute chest pain should be considered cardiovascular in origin until proven otherwise and it is common in clinical practice to err on the conservative or ‘safe’ side when evaluating people with chest pain. Individuals with suspected ischaemic chest pain must be evaluated rapidly for several reasons: - Myocardial ischaemia, if prolonged and severe, can cause myocardial infarction (necrosis); - Treatment strategies that achieve myocardial salvage (thrombolytic therapy or primary coronary angioplasty) are available for patients with acute coronary syndromes and these treatments reduce morbidity and mortality;
Throughout the body, there are several points at which blood vessels unite. The junctions are termed anastomoses. In the simplest sense, an anastomosis is any connection (made surgically or occurring naturally) between tube-like structures. Naturally occurring arterial anastomoses provide an alternative blood supply to target areas in cases where the primary arterial pathway is obstructed. They are most abundant in regions of the body where the blood supply may can be easily damaged or blocked (such as the joints or intestines). This article focuses on the arterial anastomotic networks of the upper limb.
The epididymis is a long coiled tube that lies above and behind each testicle. The epididymis collects and transports sperm from the testis to the vas deferens (tubes that transport sperm to the urethra). An epididymal cyst is a cyst-like mass in the epididymis that contains clear fluid. Typically, epididymal cysts and spermatoceles do not cause symptoms. When discovered, the epididymal cyst is usually about the size of a pea and feels separate from the top of the testis. Spermatoceles typically arise from the head of the epididymis, and are felt on the top portion of the testicle. Epididymal cysts and spermatoceles are often incidental findings on testicular self-examination or routine physical examination. It is important that any mass noted in the scrotum be examined by a urologist in order to obtain an accurate diagnosis, especially a mass on the testicle itself. Our team in the Division of Urology will typically be able to confirm the diagnosis on physical exam. However, a scrotal ultrasound may also be used in order to rule out other conditions.
Tension pneumothorax describes the progressive accumulation of air in the pleural cavity (normally a potential space) through a defect in the visceral pleura. This leads to positive pressure being maintained and increasing throughout the respiratory cycle causing vessels within the mediastinum to be compressed with catastrophic consequences if left untreated. Clinical signs include hypoxia, hypotension, tachycardia, reduced breath sounds and hyper resonance ipsilaterally, with tracheal deviation (away from the affected side) and distended neck veins being late clinical signs.