Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively a...Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively analyzed.The ultrasonic findings were observed,and the age distribution of children was analyzed.Results Among 53 cases,"cross sign"was observed in 22 cases(22/53,41.51%),and"hernia ring beak sign"was detected in 26 cases(26/53,49.06%)by preoperative ultrasound,according to which 21 cases were diagnosed as internal abdominal hernia,with the accuracy of 39.62%(21/53).Meanwhile,manifestations of intestinal obstruction were noticed in 48 cases(48/53,90.57%),and intestinal necrosis was considered in 22 cases(22/53,41.51%).Four cases were misdiagnosed as intestinal perforation,appendicitis,intestinal atresia and volvulus,each in 1 case.The onset age of postoperative adhesive band internal hernia was larger than that of mesenteric hiatal hernia(P<0.05),while no significant difference of onset age was found among other types of internal abdominal hernias(all P>0.05).Intestinal ischemic necrosis was found in 25 cases,while the incidence of intestinal necrosis in children aged≤1 year,>1 and≤3 years,>3 and≤7 years and those>7 years was 66.67%(12/18),33.33%(4/12),36.36%(4/11)and 41.67%(5/12),respectively.Conclusion The characteristic ultrasonic findings of internal abdominal hernia in children included"cross sign"and"hernia ring beak sign".Internal abdominal hernia in children under 1 year had high risk of intestinal necrosis.展开更多
In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intraute...In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.展开更多
Acquired Immunodeficiency Syndrome (AIDS) is caused by Human Immunodeficiency Viruses (HIV) resulting in progressive destruction of cell mediated immunity. The abdominal manifestations of AIDS are related to the level...Acquired Immunodeficiency Syndrome (AIDS) is caused by Human Immunodeficiency Viruses (HIV) resulting in progressive destruction of cell mediated immunity. The abdominal manifestations of AIDS are related to the level of CD+4 cells count as well as viral load. Abdominal ultrasound examination is easy to perform, non-invasive, inexpensive, readily available and reproducible investigation which provides valuable information about abdominal findings in AIDS. The objective of the study was to evaluate abdominal ultrasound findings in adult HIV/AIDS patients in Jos, Plateau State, Nigeria and correlate these findings with the patients’ CD+4 counts. A cross-sectional study of abdominal ultrasound findings of adult patients with HIV/AIDS was conducted over a period of six months. The abdominal ultrasound findings and CD+4 counts were studied. Two hundred (40%) of the patients had normal abdominal ultrasound, while 60% (300) had various abnormalities. The common abnormalities included increased liver parenchymal echogenicity in 25.0%, hepatomegaly in 23.4%, splenomegaly in 6.6%, increased splenic echogenicity in 6.2% and thickened gallbladder wall in 12.6%, elevated renal parenchymal echogenicity in 6.4%, enlarged kidneys in 2.6%, lymphadenopathy in 6.0%, and ascites in 2.4%. Pelvic abscess was the least pathology in 0.2%. Most of the findings did not correlate with the patients’ CD+4?count except for lymphadenopathy and ascites. Although abdominal ultrasound examination is invaluable in the management of these patients, however, it has not shown to be useful in predicting the patients’ immune status.展开更多
Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external,diaphragmatic and internal hernias on the basis of their localisation.Groin her...Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external,diaphragmatic and internal hernias on the basis of their localisation.Groin hernias are the most common with a prevalence of 75%, followed by femoral(15%)and umbilical(8%).There is a higher prevalence in males(M:F,8:1).Diagnosis is usually made on physical examination.However,clinical diagnosis may be difficult,especially in patients with obesity,pain or abdominal wall scarring.In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used:conventional radiographs or barium studies,ultrasonography and Computed Tomography.Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents suchas fatty tissue,bowel,other organs or fluid.This work focuses on the main radiological findings of abdominal herniations.展开更多
<strong>Background:</strong> Bilateral Ectopic Kidney is uncommon and usually diagnosed during a routine medical checkup. It could be misdiagnosed as an abdominopelvic mass. In-depth knowledge of its prese...<strong>Background:</strong> Bilateral Ectopic Kidney is uncommon and usually diagnosed during a routine medical checkup. It could be misdiagnosed as an abdominopelvic mass. In-depth knowledge of its presentation will aid in its management. A poor anatomical relation of the kidneys with other abdominopelvic organs could lead to renal complications and surgical errors. This is of gynaecological importance and worthy of discussion for a lady of her reproductive age. <strong>Case presentation:</strong> A 20-year-old nulliparous lady of African descent presented with a long-standing history of dull lower abdominal pain. The pain has been intermittent and occasionally associated with a sensation of movement in the lower abdomen. She has a regular and normal menstrual cycle and has no lower urinary tract symptoms. Physical examination was unremarkable with intact secondary sexual characteristics. The abdomen was soft, non-tender and without any organomegaly. Abdominal ultrasonography, renal pyelogram and urinalysis were carried out after her consent was sought in accordance with the institution’s protocol. Urine analysis was normal and culture was negative. However further imaging revealed a bilateral pelvic ectopic kidney. <strong>Conclusion:</strong> Most of the cases reported are usually unilateral ectopic kidneys. It is, therefore, our belief that this information will be useful to medical practitioners such as surgeons, urologists, radiologists and gynaecologists. Such a diagnosis will enable clinicians to follow up with the client and preserve the renal function whiles preventing iatrogenic injuries during surgical procedures.展开更多
AIM: To assess the cost-effectiveness of two populationbased hepatocellular carcinoma(HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography(AUS).METHODS: In ...AIM: To assess the cost-effectiveness of two populationbased hepatocellular carcinoma(HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography(AUS).METHODS: In this study, we applied a Markov decision model with a societal perspective and a lifetime horizon for the general population-based cohorts in an area with high HCC incidence, such as Taiwan. The accuracy of biomarkers and ultrasonography was estimated from published meta-analyses. The costs of surveillance, diagnosis, and treatment were based on a combination of published literature, Medicare payments, and medical expenditure at the National Taiwan University Hospital. The main outcome measure was cost per lifeyear gained with a 3% annual discount rate. RESULTS: The results show that the mass screening using AUS was associated with an incremental costeffectiveness ratio of USD39825 per life-year gained, whereas two-stage screening was associated with an incremental cost-effectiveness ratio of USD49733 per life-year gained, as compared with no screening. Screening programs with an initial screening age of 50 years old and biennial screening interval were the most cost-effective. These findings were sensitive to the costs of screening tools and the specificity of biomarker screening.CONCLUSION: Mass screening using AUS is more cost effective than two-stage biomarker-ultrasound screening. The most optimal strategy is an initial screening age at 50 years old with a 2-year inter-screening interval.展开更多
文摘Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively analyzed.The ultrasonic findings were observed,and the age distribution of children was analyzed.Results Among 53 cases,"cross sign"was observed in 22 cases(22/53,41.51%),and"hernia ring beak sign"was detected in 26 cases(26/53,49.06%)by preoperative ultrasound,according to which 21 cases were diagnosed as internal abdominal hernia,with the accuracy of 39.62%(21/53).Meanwhile,manifestations of intestinal obstruction were noticed in 48 cases(48/53,90.57%),and intestinal necrosis was considered in 22 cases(22/53,41.51%).Four cases were misdiagnosed as intestinal perforation,appendicitis,intestinal atresia and volvulus,each in 1 case.The onset age of postoperative adhesive band internal hernia was larger than that of mesenteric hiatal hernia(P<0.05),while no significant difference of onset age was found among other types of internal abdominal hernias(all P>0.05).Intestinal ischemic necrosis was found in 25 cases,while the incidence of intestinal necrosis in children aged≤1 year,>1 and≤3 years,>3 and≤7 years and those>7 years was 66.67%(12/18),33.33%(4/12),36.36%(4/11)and 41.67%(5/12),respectively.Conclusion The characteristic ultrasonic findings of internal abdominal hernia in children included"cross sign"and"hernia ring beak sign".Internal abdominal hernia in children under 1 year had high risk of intestinal necrosis.
文摘In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.
文摘Acquired Immunodeficiency Syndrome (AIDS) is caused by Human Immunodeficiency Viruses (HIV) resulting in progressive destruction of cell mediated immunity. The abdominal manifestations of AIDS are related to the level of CD+4 cells count as well as viral load. Abdominal ultrasound examination is easy to perform, non-invasive, inexpensive, readily available and reproducible investigation which provides valuable information about abdominal findings in AIDS. The objective of the study was to evaluate abdominal ultrasound findings in adult HIV/AIDS patients in Jos, Plateau State, Nigeria and correlate these findings with the patients’ CD+4 counts. A cross-sectional study of abdominal ultrasound findings of adult patients with HIV/AIDS was conducted over a period of six months. The abdominal ultrasound findings and CD+4 counts were studied. Two hundred (40%) of the patients had normal abdominal ultrasound, while 60% (300) had various abnormalities. The common abnormalities included increased liver parenchymal echogenicity in 25.0%, hepatomegaly in 23.4%, splenomegaly in 6.6%, increased splenic echogenicity in 6.2% and thickened gallbladder wall in 12.6%, elevated renal parenchymal echogenicity in 6.4%, enlarged kidneys in 2.6%, lymphadenopathy in 6.0%, and ascites in 2.4%. Pelvic abscess was the least pathology in 0.2%. Most of the findings did not correlate with the patients’ CD+4?count except for lymphadenopathy and ascites. Although abdominal ultrasound examination is invaluable in the management of these patients, however, it has not shown to be useful in predicting the patients’ immune status.
文摘Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external,diaphragmatic and internal hernias on the basis of their localisation.Groin hernias are the most common with a prevalence of 75%, followed by femoral(15%)and umbilical(8%).There is a higher prevalence in males(M:F,8:1).Diagnosis is usually made on physical examination.However,clinical diagnosis may be difficult,especially in patients with obesity,pain or abdominal wall scarring.In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used:conventional radiographs or barium studies,ultrasonography and Computed Tomography.Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents suchas fatty tissue,bowel,other organs or fluid.This work focuses on the main radiological findings of abdominal herniations.
文摘<strong>Background:</strong> Bilateral Ectopic Kidney is uncommon and usually diagnosed during a routine medical checkup. It could be misdiagnosed as an abdominopelvic mass. In-depth knowledge of its presentation will aid in its management. A poor anatomical relation of the kidneys with other abdominopelvic organs could lead to renal complications and surgical errors. This is of gynaecological importance and worthy of discussion for a lady of her reproductive age. <strong>Case presentation:</strong> A 20-year-old nulliparous lady of African descent presented with a long-standing history of dull lower abdominal pain. The pain has been intermittent and occasionally associated with a sensation of movement in the lower abdomen. She has a regular and normal menstrual cycle and has no lower urinary tract symptoms. Physical examination was unremarkable with intact secondary sexual characteristics. The abdomen was soft, non-tender and without any organomegaly. Abdominal ultrasonography, renal pyelogram and urinalysis were carried out after her consent was sought in accordance with the institution’s protocol. Urine analysis was normal and culture was negative. However further imaging revealed a bilateral pelvic ectopic kidney. <strong>Conclusion:</strong> Most of the cases reported are usually unilateral ectopic kidneys. It is, therefore, our belief that this information will be useful to medical practitioners such as surgeons, urologists, radiologists and gynaecologists. Such a diagnosis will enable clinicians to follow up with the client and preserve the renal function whiles preventing iatrogenic injuries during surgical procedures.
基金Supported by Kaohsiung Municipal Min-Seng Hospital(KMSH 9702)
文摘AIM: To assess the cost-effectiveness of two populationbased hepatocellular carcinoma(HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography(AUS).METHODS: In this study, we applied a Markov decision model with a societal perspective and a lifetime horizon for the general population-based cohorts in an area with high HCC incidence, such as Taiwan. The accuracy of biomarkers and ultrasonography was estimated from published meta-analyses. The costs of surveillance, diagnosis, and treatment were based on a combination of published literature, Medicare payments, and medical expenditure at the National Taiwan University Hospital. The main outcome measure was cost per lifeyear gained with a 3% annual discount rate. RESULTS: The results show that the mass screening using AUS was associated with an incremental costeffectiveness ratio of USD39825 per life-year gained, whereas two-stage screening was associated with an incremental cost-effectiveness ratio of USD49733 per life-year gained, as compared with no screening. Screening programs with an initial screening age of 50 years old and biennial screening interval were the most cost-effective. These findings were sensitive to the costs of screening tools and the specificity of biomarker screening.CONCLUSION: Mass screening using AUS is more cost effective than two-stage biomarker-ultrasound screening. The most optimal strategy is an initial screening age at 50 years old with a 2-year inter-screening interval.
