Presentation
Each full-color case begins with a patient presentation and proceeds through differential diagnosis, diagnosis and treatment, surgical procedures, postoperative management, and a case conclusion. [books.google.ro]
Peroperatively, 800 mL straw colored ascites was present. Right ovarian 5 Χ 5 cm and left ovarian 4 Χ 4 cm masses were present with the presence of variegated consistency and necrotic areas on cut sections. Omental caking was present. [onlinejets.org]
In the neonate, TGA is the most common condition presenting with profound cyanosis. [brainscape.com]
At present, the manatee is nursing normally and growing. [vin.com]
Hematological
- Hemophilia A
Hemophilia 2. Leukemia, lymphoma 3. Multiple myeloma 4. Metastatic carcinoma 5. Idiopathic thrombocytopenic purpura E. [radiologykey.com]
Of the following, the MOST likely cause of the bleeding is A. disseminated intravascular coagulation B. factor VIII deficiency hemophilia C. liver disease D. vitamin K deficiency E. von Willebrand disease 20- A newborn whose estimated gestational age [prep4usmle.com]
Entire Body System
- Pain
[…] lower quadrant pain, vomiting, and fever. [ahcmedia.com]
The diagnosis requires joint hypermobility and chronic widespread pain. [tamingthesru.com]
Distension activates visceral nerve pain fibers that cause pain symptoms referred to the perium-bilical area (T-10 dermatome). [elearning.sumdu.edu.ua]
Acute (Pediatric) Last Updated December 20, 2016 MODULE Abdominal Pain – Acute and Chronic Last Updated March 2, 2018 MODULE Abdominal Pain – Pediatric/Fellowship Level Last Updated June 2, 2018 MODULE Abdominal Trauma – Pediatric/Fellowship Level [surgicalcore.org]
No pain on percussion at the costovertebral angle b. Pain on deep palpation of all 4 quadrants c. The patient has stool in the rectal volt. d. The patient winces in pain when her bed is accidentally bumped e. [quizlet.com]
- Inflammation
[…] body organs 363169009 Vaginitis 30800001 Emphysematous vaginitis 8628002 ancestors sorted most to least specific Cyst of vagina 24548005 Vaginitis 30800001 Inflammation of vaginal wall 289529001 Vaginal wall finding 248878009 Inflammation of specific [findacode.com]
[…] of vagina|Inflammation of vaginal wall|Inflammation of vaginal wall (finding)|Mucopurulent vaginitis|Mucopurulent vaginitis (disorder)|NSV - Nonspecific vaginitis|Nonspecific vaginitis|PV - Vaginal infection|Pneumatosis vaginalis|Prepubertal vaginitis [averbis.com]
Its presence suggests entities that typically result in a greater degree of inflammation in the adjacent mesentery than in the bowel wall itself. [radiologykey.com]
Complications include bleeding, small bowel obstruction, inflammation (Meckel diverticulitis), and neoplasm[ 10 ]. [wjgnet.com]
[…] can originate from multiple causes: iatrogenic a medical procedure introduces gas from the external environment this might be intentional e.g. instillation of CO2 as part of laparoscopic surgery trauma vacuum phenomenon: usually no clinical sequelae inflammation [radiopaedia.org]
- Fever
1 year Circumcised boys less than 6 months Lower threshold for prolonged fever or if accompanied by vomiting Term Indications for CXR Fever > 38°C Tachypnea 0-6 months RR ≥ 59 6-12 months RR ≥ 52 12-24 months RR ≥ 42 Definition Term Fever without source [flashcardmachine.com]
Barnacle}, journal={Pediatric Radiology}, year={2010}, volume={41}, pages={129} } A 12-year-old immunosuppressed boy presented with self-limiting abdominal pain, low-grade fever and progressive scrotal swelling. [semanticscholar.org]
[…] quadrant pain, fever, leukocytosis Pericolonic inflammation, adjacent diverticulum Epiploic appendagitis Nausea and fever are rare Fatty pericolonic mass with dense rim and central high-attenuation focus Omental infarction Right-sided greater than left-sided [radiologykey.com]
[…] ssing disease-glandular fever/inf mononucleosis k!ssing ulcer-ant n post duodenal ulcers/vulval ulcer k! [aippg.net]
Clinical Image Published: 05 June 2010 Pediatric Radiology volume 41, page 129 (2011)Cite this article 859 Accesses 1 Citations Metrics details A 12-year-old immunosuppressed boy presented with self-limiting abdominal pain, low-grade fever and progressive [link.springer.com]
- Falling
Review of these cases and of 32 reported cases falling within the pediatric age range discloses that the disease occurs most frequently in patients whose general condition is poor, that it is very often associated with congenital or acquired disease of [pediatrics.aappublications.org]
Preterm babies are proportionately small & their weights fall in the normal range for the GA -use Ballard scoring system to determine GA What are 5 complications of SGA babies? 1. Fetal death 2. [cram.com]
[…] also called intestinal pneumatosis pneumatosis seasoned brown rice recipe reviews citrus pectin cystoides intestinalis or pneumatosis coli) is pneumatosis of Lyrics to ‘Heart Attack’ by Demi Lovato: So I’m putting my defenses up ‘Cause I don’t wanna fall [ediempoli.eu]
There was no history of any foreign body insertion, vigorous douching, fall, or any other trauma. Iatrogenic persistence of air in the peritoneum is unlikely to persist 10 weeks postsurgery. [onlinejets.org]
- Weakness
Celiac sprue Dx : Diarrheaa, steatorrhea, weightloss, weakness. Associated with dermatitis herpetiformis. Celiac sprue Dx : Diarrheaa, steatorrhea, weightloss, weakness. [aippg.net]
Formation of cystic spaces in mature teratoma can be due to dilatation of lymphatic vessels confirmed by FVIII positivity though only focal and weak(10). [newslab.sk]
Inguinal hernias may be caused by weak- ening of muscular aponeurosis and fascia due to age, cigarette smoking, or collagen deficiency.3,34 Weakness in the linea alba at the umbilicus leads to umbilical/paraumbilical hernia. [docsity.com]
Respiratoric
- Dyspnea
Many patients have no symptoms or nonspecific symptoms, such as chest discomfort, cough, dyspnea, or upper abdominal distress. [clinicalgate.com]
Aortic stenosis — calcific in elderly, bucuspid in congenital, angina, dyspnea, syncope, mid-late systolic murmur at base radiating to carotids, Tx with replacement (1st step) 20. [aippg.net]
[…] nystagmus pnpostnatal pnpractical nurse pnprimary nurse pnprogress note pnpyelonephritis pnpyridine nucleotide pnapartial nail avulsion pnapeanut agglutinin pncpostnecrotic cirrhosis pncprenatal clinic, premature nodal contraction PNDParoxysmal nocturnal dyspnea [medabb.com]
Case 5 A 64-year-old man was admitted to the hospital with wheezes and exertional dyspnea, which he had suffered from for several months, but without abdominal symptoms. He was diagnosed with emphysema pulmonum 1 years ago. [bmcgastroenterol.biomedcentral.com]
Severe pulmonary stenosis is characterized by all of the following features Definition a. increased right ventricular pressure b. exertional dyspnea and fatigability d. right ventricular hypertrophy on ECG Term 2. [flashcardmachine.com]
Gastrointestinal
- Abdominal Pain
[…] clinical sign than abdominal pain in these patients. [ahcmedia.com]
Level) Last Updated October 24, 2018 MODULE Abdominal Pain - Acute (Pediatric) Last Updated December 20, 2016 MODULE Abdominal Pain – Acute and Chronic Last Updated March 2, 2018 MODULE Abdominal Pain – Pediatric/Fellowship Level Last Updated June 2, [surgicalcore.org]
Pain Nuclear Medicine Bone Marrow Transplantation [link.springer.com]
For example, retrocecal appendicitis may present with vague and poorly localized pain while pelvic appendicitis can cause midline or left-sided abdominal pain. [elearning.sumdu.edu.ua]
The patient developed abdominal pain and diarrhoea. [ncbi.nlm.nih.gov]
- Vomiting
Visit our Pediatric Community Vomiting in the infant is a common and nonspecific symptom. Most causes of vomiting in this age group are benign and self-limited, including gastroesophageal reflux, milk allergies, and gastroenteritis. [appliedradiology.com]
On February 16 he began to have abdominal distention, vomited bile and had several bloody mucous stools.A scout film of the abdomen (fig. 1 A) showed gaseous distention of [jamanetwork.com]
- Diarrhea
Sx occur while fasting VIPoma Makes Vasoactive peptide (VIP); Sx WDHA (watery diarrhea, hypokalemia, achlohydria; unexplained secretory diarrhea; laparoscopy for Dx Glucagonoma tumor of alpha islet cells; 80% women; 80% malignant; Necrolytic Exfoliating [usmleforum.com]
On readmission on February 9 the patient still had diarrhea and refused to eat. At that time he weighed 4 pounds 12 ounces (2,155 Gm.). He was dehydrated and cyanotic, with stippling of the skin of the trunk. [jamanetwork.com]
The most acceptable theories concerning the pathogenesis are discussed, with their possible relation to infantile diarrhea. Received April 15, 1950. [pediatrics.aappublications.org]
Of the six patients, all complained of abdominal distention or diarrhea, three (50%) reported muco-bloody stools, two (33.3%) complained of abdominal pain. [bmcgastroenterol.biomedcentral.com]
[…] infection with gas producing bacteria, such as Clostridia ( Am J Med Sci 2006;332:100 ) Clinical features Either benign or fulminant form Often indolent clinical course, although radiographically can resemble carcinoma Patients may have nausea, vomiting, diarrhea [pathologyoutlines.com]
- Nausea
[…] insufficiency or infection with gas producing bacteria, such as Clostridia ( Am J Med Sci 2006;332:100 ) Clinical features Either benign or fulminant form Often indolent clinical course, although radiographically can resemble carcinoma Patients may have nausea [pathologyoutlines.com]
Nutrition carePatient seen for follow-up:Patient tolerating full liquids diet without nausea/vomiting. No abdominal pain. Abdomen soft, non-tender, normal bowel sounds. Loose stool-present. Abdomen soft, non-tender, normal bowel sounds. [dokumen.tips]
[…] pain Nausea and fever are rare Triangular or ovoid fatty/heterogeneous lesion deep to right anterior abdominal wall Mesenteric fat stranding can result from a broad variety of inflammatory and neoplastic disease processes; therefore, it is important [radiologykey.com]
A 23-year-old woman presents to the emergency department with a 2-day history of cramping abdominal pain, nausea, and vomiting. She also reports passing dark stools. [quizlet.com]
- Abdominal Distension
The abdominal distension resolved and the baby passed stools spontaneously after three days of treatment. The repeat abdominal radiographs showed resolution of the pneumoperitoneum. [afrjpaedsurg.org]
A newborn baby boy presents with gross abdominal distension. He is diagnosed with cystic fibrosis and his abdominal x ray shows distended coils of small bowel, but no fluid levels. [brainscape.com]
distension, no gastric air-fluid level "Football sign" = large pneumoperitoneum outlining entire abdominal cavity "Double wall sign" = "Rigler sign" = air on both sides of bowel as intraluminal gas and free air outside (usually requires >1,000 mL of [learningradiology.com]
He was noticed to have abdominal distension and feed intolerance on the sixth day of life and a lower quadrant abdominal mass was felt 48 hours later. Stool for occult blood was strongly positive. [indianpediatrics.net]
Liver, Gall & Pancreas
- Jaundice
They can occur anywhere, vary in size, & are sharply demarcated Cephalohematoma Overlying nondepressed skull fracture Jaundice = may require phototherapy This is a subperiosteal bleed due to birth trauma. [cram.com]
Risk Factors = HBV, HCV, Alcoholic cirrhosis, Aflatoxins (fungal metabolites) Benign Hep Adenomas oral contraceptives Exocrine Pancreatic CA Ductal CA, Courvoiser's Law=palpable nontender GB in a jaundiced patient is a head of Pancreas tumor. [usmleforum.com]
ERCP This baby is a full term and has > 14 days of jaundice, therefore needs an urgent conjugated bilirubin check to rule out biliary atresia. If physiological jaundice the unconjugated bilirubin levels will be increased. [brainscape.com]
Nov 14, 2007 - 12:15 AM #1 1- A 2-week-old infant is jaundiced. [prep4usmle.com]
Charcot's triad (fever, right upper quadrant pain, jaundice) suggests ascending cholangitis. If obstruction to bile flow occurs, jaundice and acholic stools are seen. [elearning.sumdu.edu.ua]
Skin
- Eruptions
[…] pelpermissible exposure level pelprimary effusion lymphoma pempolymorphic epithelial mucin pemprotein energy malnutrition pemtphosphatidylethanolamine methyltransferase penpenicillin pepparietal epithelial cell pepphosphoenolpyruvate peppolymorphic eruption [medabb.com]
- Skin Ulcer
Skin ulceration or an episode of incarceration should prompt earlier repair. Large defects with significant protrusion may necessitate surgery, and parents may desire repair if an older child appears to be self-conscious about the hernia. [basicmedicalkey.com]
Musculoskeletal
- Muscle Cramp
McArdles Disease musclephosphorylase is absent, muscle cramps & incr. myoglobin after exercise Jaundice Prehepatic = hemolysis, gilbert's disease, Crigler Najjar; Hepatic = hepatocellular or cholestatic; Post Hepatic = Biliary obstruction, AST & LDH also [usmleforum.com]
Neurologic
- Seizure
The blooc counts & chemistries are normal What are 2 possible metabolic causes of seizures? Hypoglycemia & Hypocalcemia What is the MCC of neonatal seizures? Hypoxic-ischemic encephalopathy - - - - [cram.com]
"The syndrome frequently involves cerebellar dysfunction and more rarely involves seizures or EEG abnormalities. [pusware.com]
At 6 hours of age, the infant has a generalized tonic-clonic seizure. [prep4usmle.com]
[…] discharge from the hospital; subdural or intracerebral hemorrhage confirmed by mean of ultrasonography, computed tomography [CT], or magnetic resonance imaging [MRI]); Apgar score of less than 4 at 5 minutes; coma, stupor, or decreased response to pain; seizures [nejm.org]
Urogenital
- Dysuria
More specific urinary symptoms, such as dysuria and hematuria may be present. A history of pneumaturia may be seen but is not common. Most often the diagnosis is made incidentally during an imaging examination. [radiopaedia.org]
[…] management, with the latter requiring ceftriaxone 250 mg IM + 14 days of oral antibiotics Cystitis One in 5 women diagnosed with a UTI tested for and were positive for Chlamydia, making urethritis a consideration in all patients presenting with UTI symptoms Dysuria [tamingthesru.com]
A 4 year old boy presents with symptoms of dysuria and urinary frequency. A urine dipstick is positive for blood and nitrites. A UTI is suspected. Which of the following follow up strategies is most appropriate? A. Watchful waiting B. Cystoscopy C. [brainscape.com]
Similarly, irritative voiding symptoms (e.g., dysuria or frequency) can occur when an inflamed appendix is lying near the ureter or bladder. [elearning.sumdu.edu.ua]
Clinical symptoms of dysuria, increased urinary frequency, and hematuria are common. The presence of pneumaturia is a rare, although more specific, clinical finding. [pubs.rsna.org]
- Urinary Retention
Urinary retention and indwelling catheters are predisposing factors. The abscess may be drained via either transurethral or transrectal route. Where urinary retention exists suprapubic catheterisation may be preferred to avoid seeding of infection. [epos.myesr.org]
Retention Last Updated January 18, 2018 [surgicalcore.org]
- Dyspareunia
CASE REPORT A 43-yr-old woman presented with a 12-mo history of worsening menorrhagia and dyspareunia. She had no significant medical history and in particular no history of immunosuppression, diabetes, or hormonal therapy. [docksci.com]
Workup
Despite its antiquity, radiography continues to be used as the first-line imaging technique to evaluate various abdominal conditions, providing important clues directing subsequent workups. [accesspediatrics.mhmedical.com]
Take Away Points The majority of neonates are not sick Adequate history is pivotal Keep a broad differential but workup should be tailored Reach out for help [tamingthesru.com]
Other associated anomalies such as congenital heart disease, genitourinary tract malformations, and musculoskeletal disorders are common in these infants, and appropriate preoperative workup is necessary. [basicmedicalkey.com]
[…] appreciable amount of fecal mate- rial that may continue to pass for some time.5,6 RADIOLOGIC EVALUATION OF BOWEL OBSTRUCTION Plain Abdominal Radiographs The plain radiograph of the abdomen has tradition- ally been used as the first radiologic study in the workup [docsity.com]
Emergent is when there are signs of end-organ damage (must admit and do workup). 32. [aippg.net]
Treatment
Treatment: primary abdominal wall closure, TPN; Silastic silo if unreducible Omphalocele (“good bowel, bad baby”) bowel hernia with peritoneal covering. [dailyabsitequestions.blogspot.com]
In PI associated with conditions in which surgical treatment has no role and no other definitive treatment exists, excellent results have been reported with use of inspired oxygen as a treatment.128,129 Original studies130,131 suggested maintaining arterial [jamanetwork.com]
(a) Pre-treatment axial contrast-enhanced CT of the pelvis demonstrates the surgical anastomosis (arrows) prior to commencement of treatment, with mild pre-sacral soft tissue thickening (arrowhead). [ncbi.nlm.nih.gov]
Abstract The usual accepted mode of treatment of neonates with necrotizing enterocolitis (NEC) and pneumoperitoneum is surgical. However, in a select group of patients conservative treatment is feasible. [afrjpaedsurg.org]
Inhalational and hyperbaric oxygen therapy have also been used for the treatment of PCI. [lungdiseasesjournal.com]
Prognosis
This finding suggests that age at NEC onset may affect prognosis in full-term infants. [nature.com]
It has a poor prognosis and requires prompt antimicrobial treatment and emergent drainage or removal of the infected kidney (1, 2). [epos.myesr.org]
Uniformly, the prognosis has been grave with only 4 cases being diagnosed antemortem leading to surgical intervention and antifungal therapy and only 3 survived(3,5,9). [indianpediatrics.net]
Treatment and prognosis Treatment involves urinary catheterization, antibiotic therapy and control of underlying diabetes. Gas within the bladder wall is virtually always due to emphysematous cystitis. [radiopaedia.org]
Summary This patient had a really good prognosis and outcome. No enteral or parenteral nutrition was needed during hospitalization and patient tolerated diet progression well. [dokumen.tips]
Etiology
Table 1 Etiology of primary pneumoscrotum Table 2 Etiology of secondary pneumoscrotum Etiology The accumulation of air or gas in the scrotum occurs by different mechanisms. [karger.com]
Dis Colon Rectum 19: 107, 1976 PubMed CAS Google Scholar Yale CE, Balish E, Wu JP: The bacterial etiology of pneumatosis cystoides intestinalis. [link.springer.com]
Another common etiology of PI in nontransplant patients is intestinal ischemia; however, due to the nonwatershed distribution and time frame, late postsurgical, seen in our patient population, this does not appear to be a potential etiology. [hindawi.com]
Endometrial pneumatosis remains an enigmatic condition of uncertain etiology but it appears to be self-limited with no known pathologic sequelae. Departments of Histopathology (Y.J.C., C.J.R.S.) [dev-journals2013.lww.com]
The etiology of pneumatosis is not completely understood but 2 broad categories, infective and noninfective, are recognized. [docksci.com]
Epidemiology
Further understanding of the epidemiology of these infections and their sequelae are needed to formulate public health strategies. ( 2 )( 3 ) Objectives After completing the article, the reader should be able to: Appreciate the epidemiology and risk factors [pedsinreview.aappublications.org]
Despite various epidemiological studies reporting prevalence of DM in Turkey, there is no meta-analysis or systematic review evaluating these studies ... [acikerisim.cumhuriyet.edu.tr]
Balbaa Enzymes Characterization in Diabetes mellitus PPT Version | PDF Version Borzenko Berta Georgiyevna Disoders of Purine and Pyrimidine Nucleotides Metabolism in Human Gastrointestinal Tract Cancer PPT Version | PDF Version Tarek Mohmmed Tawfik Amin Epidemiology [omicsonline.org]
Google Scholar European Center for Disease Control and Prevention: Annual epidemiological report 2012. [bmcinfectdis.biomedcentral.com]
The epidemiology of perinatal mortality in multiple births. Bull N Y Acad Med 1990 ;66: 618 - 637 4. Ghai V, Vidyasagar D. Morbidity and mortality factors in twins: an epidemiologic approach. Clin Perinatol 1988 ;15: 123 - 140 5. [nejm.org]
Pathophysiology
Prematurity and low birthweight ( NEC is a multifactorial disease with an unclear pathophysiology. [hawaii.edu]
Draw your own conclusions, or at least think about the ramifications of our ability to salvage patients from what had historically been death sentences with advances in critical care and increased understanding of the pathophysiology of SIRS/multiple [buckeyesurgeon.com]
Dilated bowel loops on X-ray are a non-specific sign and may also be present in normal premature babies; other clinical and pathophysiological signs are required to make a diagnosis of NEC. [ep.bmj.com]
The absence of a definitive causal theory of PCI and the variety of treatments which have been reported reflect our current lack of knowledge regarding the underlying pathophysiology of PCI. [lungdiseasesjournal.com]
Current clinical and experimental data support the concept that the pathophysiology of NEC remains enigmatic and multifactorial. [basicmedicalkey.com]
Prevention
[…] a lack of clinical awareness and optimal diagnostic tests and limited means for therapy and prevention. [pedsinreview.aappublications.org]
Supplementing fiber along with the enteral tube feeding may help prevent overgrowth of pathogenic bacteria, as well as helping in the prevention of septic complications. [dokumen.tips]
[…] minus' sign Virchow -triad Use Parentheses water AND (cup OR glass) Add an asterisk (*) at end of a word to include word stems Neuro* will search for Neurology, Neuroscientist, Neurological, and so on Use quotes to search for an exact phrase "primary prevention [read.qxmd.com]
The elusiveness of the etiology of NEC has made it difficult to establish effective preventive measures. [hawaii.edu]
Localised abdominal compartment syndrome: bladder-over-gastric pressure ration (B/G ratio) as a clue to diagnosis MALBRAIN MLNG, DE LAET IE, WILLEMS A et al. abstract details 107 - 114 - Are ACE-inhibitors or ARB's still needed for cardiovascular prevention [poj.peeters-leuven.be]