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This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.
In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.
***Thanks to the patient for sharing his history and exam with YouTube world***
Finding a donor heart can be difficult. The heart must be donated by someone who is brain-dead but is still on life support. The donor heart must be matched as closely as possible to your tissue type to reduce the chance that your body will reject it. You are put into a deep sleep with general anesthesia, and a cut is made through the breastbone. Your blood flows through a heart-lung bypass machine while the surgeon works on your heart. This machine does the work of your heart and lungs while they are stopped, and supplies your body with blood and oxygen. Your diseased heart is removed and the donor heart is stitched in place. The heart-lung machine is then disconnected. Blood flows through the transplanted heart, which takes over supplying your body with blood and oxygen. Tubes are inserted to drain air, fluid, and blood out of the chest for several days, and to allow the lungs to fully re-expand.
Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease (IBD) that causes long-lasting inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly. Ulcerative colitis can be debilitating and sometimes can lead to life-threatening complications. While it has no known cure, treatment can greatly reduce signs and symptoms of the disease and even bring about long-term remission.
Signs and symptoms of colon cancer include: A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks Rectal bleeding or blood in your stool Persistent abdominal discomfort, such as cramps, gas or pain A feeling that your bowel doesn't empty completely Weakness or fatigue Unexplained weight loss Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they'll likely vary, depending on the cancer's size and location in your large intestine.
#ComprehensiveClinicalClass
History, Examination and Management of Hernia
Mentor: Dr. Nishanth, Consultant Surgeon, Bengaluru.
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Dr. James Wall performs a bilateral inguinial hernia repair surgical procedure.
Featured:
James Wall, MD
Assistant Professor of Surgery, Pediatric Surgery
Assistant Professor of Bioengineering (By Courtesy)
Lucile Salter Packard Children's Hospital
Micaela Esquivel, MD
Chief Resident of General Surgery
A surgeon begins the PPH stapled hemorrhoidectomy by inserting a circular anal dilator and obturator into the anal canal and then securing the dilator in place with four sutures. The surgeon then inserts a PPH anoscope into the obturator. Next, he places a circumferential purse-string suture of 2-0 Monocryl on a UR-6 needle 4 cm proximal to the dentate line. The surgeon opens a PPH stapler and places its anvil across the purse string. The stapler is then closed and fired; it is held closed for two minutes to improve hemostasis. Prior to firing the stapler in a female patient, the surgeon places a gloved finger in the vagina to ensure the vaginal mucosa and rectal-vaginal septum are not trapped within the jaws of the closed stapler. The surgeon then opens and removes the stapler.
Primary sclerosing (skluh-ROHS-ing) cholangitis (koh-lan-JIE-tis) is a disease of the bile ducts, which carry the digestive liquid bile from your liver to your small intestine. In primary sclerosing cholangitis, inflammation causes scars within the bile ducts. These scars make the ducts hard and narrow and gradually cause serious liver damage. In most people with primary sclerosing cholangitis, the disease progresses slowly and can lead to liver failure, repeated infections, and tumors of the bile duct or liver. Liver transplant is the only known cure for primary sclerosing cholangitis. The search for other treatments to slow or stop primary sclerosing cholangitis is ongoing, and scientists have turned up many promising leads. Until better treatments are proved safe and effective, though, care for primary sclerosing cholangitis focuses on monitoring liver function, managing symptoms and, when possible, doing procedures that temporarily open blocked bile ducts.
The vulvar vaginal diseases service sees referrals to help women with short--and long--term problems of the outer genital area (vulva), vagina and pelvic floor muscles including: Vulvar vaginal burning, itching, irritation and pain Vulvar Vestibulitis Pain with intercourse Discharge Yeast infections Bacterial vaginosis Pelvic floor muscle dysfunction A patient must be referred by her local health care provider. Services include: Skin care education Examinations-Your healthcare provider will examine you and talk with you about recommendations for treatment and/or management of your symptoms. Some vulvar diseases require a biopsy to diagnose the condition. Referrals-Your healthcare team may refer you to other specialists, including physical therapists or health psychologists. Separate insurance authorization is necessary for these services. The clinic staff provides general education and support to help women cope with these very personal health problems. Following a clinic visit, a letter is promptly sent to your local health care provider. The letter provides the results of your exam and the plan of care.