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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.

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Sclerotherapy is a procedure used to eliminate varicose veins and spider veins. Sclerotherapy involves an injection of a solution (generally a salt solution) directly into the vein. The solution irritates the lining of the blood vessel, causing it to collapse and stick together and the blood to clot.Sep 17, 2016

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Open heart (coronary artery bypass, or CABG) surgery is performed in order to reroute, or "bypass," blood around blocked arteries, thereby improving the supply of oxygen-rich blood to the heart. Surgeons usually use an artery from the chest wall to construct the "detour" around the blocked part of the artery. Veins from the legs are also used.

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There can be a number of psychological triggers that cause nightmares in adults. For example, anxiety and depression can cause adult nightmares. Post-traumatic stress disorder (PTSD) also commonly causes people to experience chronic, recurrent nightmares. Nightmares in adults can be caused by certain sleep disorders

Basic ECG Interpretation Our ECG Interpretation Training and Reference Guides provide basic lessons for ECG analysis as well as a quick reference guide for over 40 types of ECG tracings. The arrhythmia drills and quizzes allow you to practice ECG interpretation. What is ECG Interpretation? An electrocardiogram or ECG, records electrical activity in the heart. An ECG machine records these electrical signals across multiple heart beats and produces an ECG strip that is interpreted by a healthcare professional. How Electrocardiograms Work - ECG Strips To briefly summarize the components of a normal ECG tracings, it consist of waveform components which indicate electrical events during one heart beat. These waveforms are labeled P, Q, R, S, T and U. P wave is the first short upward movement of the ECG tracing. It indicates that the atria are contracting, pumping blood into the ventricles. The QRS complex, normally beginning with a downward deflection, Q; a larger upwards deflection, a peak (R); and then a downwards S wave. The QRS complex represents ventricular depolarization and contraction. The PR interval indicates the transit time for the electrical signal to travel from the sinus node to the ventricles. T wave is normally a modest upwards waveform representing ventricular repolarization. ECG Interpretation illustration spacer image ECG Training - Introduction The focus of this introductory ECG course is to provide a tutorial about the main features of ECGs along with a method for analyzing ECGs. This method includes assessment of rhythm, calculating heart rate, observing P-wave forms, measurement of intervals and segments and the evaluation of other relevant waves. ECG practice exercises serve to reinforce the lesson content.

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Mastitis is inflammation of tissue in one or both mammary glands inside the breast. Mastitis usually affects lactating women - women who are breastfeeding, producing milk. Hence, it is often referred to as lactation mastitis. The patient feels a hard, sore spot inside the breast.

Paronychias are most often caused by common skin bacteria (most commonly staphylococci bacteria) entering the skin around the nail that has been damaged by trauma, such as nail biting, finger sucking, dishwashing, or chemical irritants. Fungal infection also can be a cause of paronychia formation and should be considered especially in people with recurrent infection. Paronychia should not be confused with herpetic whitlow, which can form tiny pustules on the finger and is caused by a virus but is not typically located at the nail edge. Herpetic whitlow is not treated with an incision and drainage and therefore needs to be distinguished from a paronychia.

Pulmonary circulation is the portion of the cardiovascular system which carries deoxygenated blood away from the heart, to the lungs, and returns oxygenated (oxygen-rich) blood back to the heart. The function of pulmonary circulation is to exchange carbon dioxide for oxygen in the blood. It is the passage of blood from the heart to the capillaries of the lungs, where the gases are exchanged, and back to the heart to be pumped around the body.