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A 30 YEAR WOMEN WITH INTRACTABLE BILIARY COLIC
CASE REPORT: This 30 year women developed severe pain right upper quadrant for last 10 days. She sought many consultations and was given intravenous analgesics both (nonnarcortic and narcotic). Pain did not subside and she sought my consultation. Examination revealed her to be in agony with severe upper abdominal pain. General physical examination was otherwise unremarkable. Abdominal examination revealed mild tenderness in right hypochondrium with doubtful Murphy's sign. Urgent abdominal ultrasound showed a linear structure in bile ducts making slow writhing movements. The structure had an anechoic tube (alimentary canal) inside suggestive of a large Ascarid. Urgent ERCP was performed and bile duct and pancreatic duct cannulated selectively. Pancreatic duct was normal. Bile ducts contained a long linear filling defect extending from lower end of common bile duct to right intrahepatic duct (see image gallery for ERCP plate). A basket was introduced in the duct (see video clip) and the linear structure was engaged with soft closure and extracted out of the bile duct. Accompanying the basket was a 25 cm thick highly motile Ascarid. To recover the worm, endoscope was withdrawn along with the basket and the friendly catch. While the endoscope was being withdrawn and the basket was in the duodenum with the worm out of bile duct, patient indicated of relief of abdominal pain. A relook cholangiogram showed no more structures in the duct. She was given antihelmintic therapy and passed hundreds of worms with the feces. The worms recovered form stools were both male and female population and varied in length and size. However the lone worm recovered form bile ducts was the longest and the thickest male worm. The phenomenal behavior of this ubiquitous infection remains unexplained.
Watch as Dr. Benjamin Carson performs risky brain surgery on young Payton to remove a brain tumor. Dr. Carson, director of pediatric neurosurgery, is just one of the many reasons why Johns Hopkins Children's Center was recently ranked #1 in neurology and neurosurgery in America's Best Children's Hospitals 2008
Your temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn. Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD). But you may hear it wrongly called TMJ, after the joint.
Three to five years after gastric bypass surgery, some patients start to regain weight because the size of their stoma (the opening at the bottom of the stomach pouch) or their stomach pouch itself has increased. This can keep you from feeling full after small meals.
To resolve this problem, our surgeons use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. The surgeon performs the procedure entirely through the mouth -- inserting an endoscope under heavy sedation -- so there are no external incisions into the body.
How to perform a parotidectomy gland resection? In this video we take you step by step through the protid gland resection surgical technique. This video is intended for ENT residents and Head and Neck Surgery Surgeons. It is part of the ORL-Information's Head and Neck surgery Masterclass in collaboration with the University Hospital of Nîmes. Surgeons Editors: Pr. Benjamin LALLEMANT, MD, PhD - Dr. Camille GALY, MD Head and and Neck Department, University Hospital of Nîmes, France Official video | www.orl-information.fr
Cette vidéo présentent la technique de la parotidectomie avec dissection du nerf facial. Elle illustre les différents temps de l'intervention notamment le temps de repérage du nerf facial.
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Central catheters provide dependable intravenous access and enable hemodynamic monitoring and blood sampling [1-3]. The jugular veins are one of the most popular sites for central venous access due to accessibility and overall low complication rates, and are the preferred site for temporary hemodialysis.
Surgery involves removing the cyst as well as part of the involved joint capsule or tendon sheath, which is considered the root of the ganglion. Even after excision, there is a small chance the ganglion will return. A ganglion cyst at the wrist is removed during a surgical procedure called excision.