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Acute otitis media: Inflammation of the middle ear in which there is fluid in the middle ear accompanied by signs or symptoms of ear infection: a bulging eardrum usually accompanied by pain; or a perforated eardrum, often with drainage of purulent material (pus).
Anoscopy performed with the patient in the jackknife position is demonstrated in this educational video. Anoscopy uses a short, lighted instrument to examine the anal canal and lower rectum. A clinical-skills resource for students of colorectal examination. Educational only — not medical advice.
Mesenteric cyst is one of the rarest abdominal tumours, with approximately 820 cases reported since 1507. The incidence varies from 1 per 100,000 to 250,000 admissions. The lack of characteristic clinical features and radiological signs may present great diagnostic difficulties.
An ileostomy is an opening in the belly (abdominal wall) that’s made during surgery. The end of the ileum (the lowest part of the small intestine) is brought through this opening to form a stoma, usually on the lower right side of the abdomen. A Wound Ostomy Continence nurse (WOCN or WOC nurse) or the surgeon will figure out the best location for your stoma. (A WOC nurse is a specially trained registered nurse who takes care of and teaches ostomy patients. This nurse may also be called an ostomy nurse.)
Support and encouragement during a natural water birth are the focus of this recording, which follows a laboring mother in a birthing pool with her birth team around her. It shows the supportive role of midwives and partners during delivery. Shared for childbirth education. For learning purposes only — not medical advice.
Surgical technique: A 3cm skin incision under spinal or general anesthesia, depending on the patients’ preference, starts half way the line between the superior anterior iliac spine towards the midline in a 30° angle to the pubic tubercle. Scarpa’s fascia is opened as well as the external obliq...ue aponeurosis. By using this skin line incision the internal ring will be immediately visualized. Although it is important to look for both direct and indirect hernias evaluating the groin, we do not taper the cord and directly evaluate the ring for indirect hernias. In case of an indirect hernia the sac is reduced or resected according to the preference of the surgeon and the preperitoneal space is entered bluntly through the dilated internal ring. In case of a direct hernia the approach slightly differs. One could prefer to open the transversalis fascia through the internal ring over a few centimeters or you can open the fascia more medially, at the site of the direct hernia. As primary point of concern the epigastric vessels should be identified and retracted softly upwards. Then a gauze can be introduced into the preperitoneal space and by doing so most of the space needed medially will be created. Then one can already palpate Cooper’s ligament and the pubic bone. Laterally to the internal ring more digital dissection is needed to create just the appropriate space for the mesh. By placing the mesh it is important not to introduce the mesh too medially. Laterally of the internal ring an adequate overlap of the mesh is necessary, especially in indirect hernias. No splitting of the mesh seems necessary. The patient will be asked to strain and push on the ring to control its place and to check adequate spreading of the mesh to cover the whole myopectineum of Fruchaud. One single stitch of vicryl 3/0 is placed taking both the fascia transversalis and the mesh.