To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt positionon the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the diameterand ...To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt positionon the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the diameterand blood flow velocity of the right femoral vein of 18 patients undergoing gynecologic laparoscopy under the same pressure ofpneumoperitoneum of 12 mmHg. The diameter of femoral vein and the flow velocity were measured; the blood flow volumewas calculated based on the equation of Q = vπr2 . Result: After establishment of pneumoperitoneum, the dilation of the fem-oral vein and the decrease in the velocity and volume can be observed (P ＜ 0.05). And the 30 degree head-down positioncould increase the flow velocity and volume of the femoral vein and decrease the diameter of the vessel ( P ＜ 0.05). At 30minutes of the 30 degree head-down tilt position, the blood flow ameliorated compared with that in prone position after theestablishment of pneumoperitoneum. After deflation of pneumoperitoneum, the femoral vein remained dilated( P ＜ 0.05 ).Conclusion: During laparoscopy, CO2 pneumoperitoneum may result in the dilation of the vein in lower extremity and retar-dance of blood flow. The 30 degree Trendlenburg position can ameliorate the blood flow in the lower extremity. The deflationof the pneumoperitoneum cannot eliminate the effect of CO2 pneumoperitoneum on the lower extremity veins, which may pre-dispose deep venous thrombosis after laparoscopy.展开更多
Perforation of Meckel’s diverticulum (MD) during the neonatal period may occur in the presence of distal colon obstruction.Herein,we describe a unique case of a 2-day-old infant that presented with pneumoperitoneum,i...Perforation of Meckel’s diverticulum (MD) during the neonatal period may occur in the presence of distal colon obstruction.Herein,we describe a unique case of a 2-day-old infant that presented with pneumoperitoneum,in which a perforated MD was induced by distal intestinal obstruction secondary to totalcolonic aganglionosis. In the setting of neonatal perforated MD found intraoperatively,the determination of the possible precipitating etiology is necessary. The clinical history of delayed passage of meconium is emphasized,and either a rectal or colon biopsy is recommended intraoperatively to avoid overlooking the associated presence of Hirschsprung’s disease.展开更多
新生儿坏死性小肠结肠炎(Necro-tizing enterocolitis,NEC)X 线表现有助于早期诊断,了解病变发展过程,从而确定保守或手术治疗方案,目前仅上海、北京、广州、南京、重庆、广西、苏州7个医疗中心就报告665例,有日渐增多趋势。本文就 NEC ...新生儿坏死性小肠结肠炎(Necro-tizing enterocolitis,NEC)X 线表现有助于早期诊断,了解病变发展过程,从而确定保守或手术治疗方案,目前仅上海、北京、广州、南京、重庆、广西、苏州7个医疗中心就报告665例,有日渐增多趋势。本文就 NEC 的 X 线表现与临床关系作一扼要综述。展开更多
文摘To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt positionon the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the diameterand blood flow velocity of the right femoral vein of 18 patients undergoing gynecologic laparoscopy under the same pressure ofpneumoperitoneum of 12 mmHg. The diameter of femoral vein and the flow velocity were measured; the blood flow volumewas calculated based on the equation of Q = vπr2 . Result: After establishment of pneumoperitoneum, the dilation of the fem-oral vein and the decrease in the velocity and volume can be observed (P ＜ 0.05). And the 30 degree head-down positioncould increase the flow velocity and volume of the femoral vein and decrease the diameter of the vessel ( P ＜ 0.05). At 30minutes of the 30 degree head-down tilt position, the blood flow ameliorated compared with that in prone position after theestablishment of pneumoperitoneum. After deflation of pneumoperitoneum, the femoral vein remained dilated( P ＜ 0.05 ).Conclusion: During laparoscopy, CO2 pneumoperitoneum may result in the dilation of the vein in lower extremity and retar-dance of blood flow. The 30 degree Trendlenburg position can ameliorate the blood flow in the lower extremity. The deflationof the pneumoperitoneum cannot eliminate the effect of CO2 pneumoperitoneum on the lower extremity veins, which may pre-dispose deep venous thrombosis after laparoscopy.
文摘Perforation of Meckel’s diverticulum (MD) during the neonatal period may occur in the presence of distal colon obstruction.Herein,we describe a unique case of a 2-day-old infant that presented with pneumoperitoneum,in which a perforated MD was induced by distal intestinal obstruction secondary to totalcolonic aganglionosis. In the setting of neonatal perforated MD found intraoperatively,the determination of the possible precipitating etiology is necessary. The clinical history of delayed passage of meconium is emphasized,and either a rectal or colon biopsy is recommended intraoperatively to avoid overlooking the associated presence of Hirschsprung’s disease.
文摘新生儿坏死性小肠结肠炎(Necro-tizing enterocolitis,NEC)X 线表现有助于早期诊断,了解病变发展过程,从而确定保守或手术治疗方案,目前仅上海、北京、广州、南京、重庆、广西、苏州7个医疗中心就报告665例,有日渐增多趋势。本文就 NEC 的 X 线表现与临床关系作一扼要综述。
