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At least 289 records · Page 16Linked to original sources
PubMed2000

Helical CT protocols for the abdomen and pelvis: a survey.

OBJECTIVE: We surveyed members of the Society of Computed Body Tomography/Magnetic Resonance to evaluate current techniques used for helical CT in the abdomen and pelvis. MATERIALS AND METHODS: The survey was distributed to 70 members (36 institutions) of the Society of Computed Body Tomography/Magnetic Resonance. The survey included general questions related to abdominal and pelvic helical CT and also asked the members to write a protocol for 12 hypothetical requisitions. RESULTS: Thirty-two members (46%) responded, representing 28 institutions (78%). The number of protocols for helical CT of the abdomen and pelvis at each institution ranges from 2 to 35 (median, 11). IV contrast material is administered for 90% (median) of abdominal and pelvic CT examinations. Nonionic contrast material is used for 68% (median) of these examinations. IV contrast material is used by 100% of institutions for tumor staging protocols except for one institution that does not use IV contrast material for lymphoma staging. Fifty percent of the institutions obtain two- or three-phases of liver images for breast cancer staging. For all protocols, the average collimation and reconstruction interval is 7 mm except for renal (5 mm) and adrenal (4 mm) protocols. Rectal contrast material is administered most commonly for colon cancer staging (39% of institutions). CONCLUSION: There is a wide range in the number of protocols used for helical CT in the abdomen and pelvis among the responding institutions. Most protocols include use of nonionic IV contrast material injected at a rate of 3 ml/sec and a collimation of 7 mm.

Clinical Protocols↗
PubMed1999

[Contrast-enhanced 3D MR-angiography of the thorax, abdomen and lower extremities].

Contrast-enhanced 3D MR angiography permits comprehensive assessment of the arterial system in the chest, abdomen und lower extremities. The method combines intravenous bolus application of a non-nephrotoxic, paramagnetic, extracellular contrast agent with the acquisition of a fast 3D data set. High contrast between the vascular lumen and surrounding tissues, inherent three-dimensionality and the ability to collect image data in the chest and abdomen under apnea conditions all contribute to excellent image quality. Contrast-enhanced 3D MRA is being employed in many centers throughout the world for the evaluation of various arterial pathologies. This review provides a technical overview and critically discusses the clinical applications in the chest, abdomen and lower extremities based upon the available literature and several clinical examples.

Aorta, Abdominal↗
PubMed2002

[A discussion on utility and purposed value of obesity and abdomen obesity when body mass index, waist circumference, waist to hip ratio used as indexes predicting hypertension and hyper-blood glucose].

OBJECTIVE: Discussion on utility and purposed value of obesity and abdomen obesity when body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) used as indexes predicting hypertension, hyper-blood glucose, and both clusters, to provide scientific basis for the decision on the indexes and their cut-off points of obesity and abdomen obesity in Chinese people. METHODS: Using the data of diabetes mellitus (DM) from epidemiological studies carried out in 11 provinces/autonomous regions/municipalities of China from July 1995 to June 1997. Partial relative analysis, logistic multi-factors regression analysis, interaction analysis were used. Relative risk (RR), attributable risk proportion (ARP) and population attributable risk proportion (PARP) of hypertension, hyper-blood glucose, and the both cluster as BMI, WC, WHR with the different cut off points were analysed. RESULTS: 1) The correlations between BMI, WC and blood pressure, blood glucose were better than the WHR. 2) After adjusted by age, sex, occupation leisure physical activity, education degree and the family history of DM, the results suggested that BMI, WC, WHR were important predictive factors, with relative importance as BMI > WC > WHR. 3) There were augment interactions on BMI, WC and WHR with hypertension, hyper-blood glucose, with the interaction of BMI and WC in particular. Their pure attributable interaction proportion were from 5.95% to 29.34%. 4) The values of RR were about 2.5 when BMI >/= 23, >/= 24 and >/= 25, suggesting the relationship with exposure factors and diseases were with medium and high maleficent extent. Their ARP were from 0.580 to 0.623 with PARP from 0.259 to 0.425. The values of RR were from 2.06 to 3.08 as WC >/= 85 cm in males, WC >/= 80 cm in females while WC >/= 90 cm in males, WC >/= 80 cm in females, which suggested that the relationship with exposure factors and diseases were in medium and high maleficent extent. Their ARP were from 0.515 to 0.676 while PARP from 0.241 to 0.431. CONCLUSIONS: Since the maleficent extent of exposure factors to diseases, the acceptability for overweight and obesity in population, and the prevention and care for overweight and obesity were just in the introduction stage in China. The utility value of predicted hypertension, hyper-blood glucose in BMI and WC seemed to be better then in WHR. We suggested that BMI used as the obesity index, with the diagnostic cut-off point BMI >/= 24. WC as the abdomen obesity index. The diagnostic cut-off points are suggested to be WC >/= 85 cm in males, and WC >/= 80 cm in females.

Adult↗
PubMed2002

[Selective approach to the penetrating stab wounds to the abdomen].

BACKGROUND: To present the results of the selective treatment on the penetrating stab wound to the abdomen METHODS: From December 1997 to February 200, 175 patients had penetrating stab wound injuries to the abdomen. Of the 175 patients, 61 (34.9%) in Group I were taken to the operating room urgently, 114 (65.1%) in Group 11 were treated selectively. RESULTS: It is evident that the rate of unnecessary laparotomies (X2=6.7, p=0.03), morbidity rate (X2=15.4, p<O.OO1), and hospital stay (F=54, p<O.OOO1 ) in the selectively treated group decrease significantly when compared with the non-selective group. CONCLUSION: Selective approach to the penetrating stab wounds to the abdomen is a safe method. Furthermore, this method obviates most of the unnecessary laparotomies. For this reason, morbidity rate and hospitalization decrease significantly. Key words: Conservative treatment, unnecessary laparotomy, morbidity, hospital stay.

Abdominal Injuries↗
PubMed2001

Auscultation of the Chest and Abdomen by Athletic Trainers.

OBJECTIVE: To present a practical overview of the methods and techniques of auscultation of the chest and abdomen for use during the physical examination of athletes. Our intent is to provide information on this clinical technique to assist athletic trainers in recognizing and referring athletes presenting with potentially serious internal organ conditions. BACKGROUND: Use of the stethoscope is a clinical skill increasingly necessary for athletic trainers. Given the expanding breadth of both the assessment techniques used by athletic trainers and the populations they care for and the fact that clinical instruction guidelines have changed in the newly adopted National Athletic Trainers' Association Educational Competencies, our goal is to provide a framework upon which future instruction can be based. DESCRIPTION: This review covers the use of a stethoscope for auscultation of the chest and abdomen. Auscultation of the heart is covered first, followed by techniques for auscultating the breath sounds. Lastly, auscultation of the abdomen describes techniques for listening for bowel sounds and arterial bruits. CLINICAL ADVANTAGES: During the assessment of injuries to and illnesses of athletes, knowledge of auscultatory techniques is valuable and of increasing importance to athletic trainers. Athletic trainers who do not know how to perform auscultation may fail to recognize, and therefore fail to refer for further evaluation, athletes with potentially serious pathologic conditions.

Journal Article↗
PubMedDate not supplied

[Open vs. closed abdomen in acute peritonitis. A comparative study].

INTRODUCTION: Open abdomen is a management alternative that, however, is not exempt from complications. We evaluated, in a comparative manner, the handling with open abdomen (OA) against closed abdomen (CA) in treatment of patients with severe peritonitis for traumatic lesion. MATERIAL AND METHODS: We carried out an observational, retrospective, longitudinal, and comparative study. It included patients managed with diagnosis severe peritonitis due to abdominal trauma between 1998 and 2000. They were divided into two groups, according to management with OA or CA. We compared age, sex, trauma type, severity of lesion, morbility and mortality. RESULTS: 12 patients were managed with OA, which presented longer hospitalization and 24 with CA who in turn presented a greater lesion severity. There were statistical differences in other parameters, including complications and mortality. However, patients managed with OA frequently presented more complications. DISCUSSION: OA does not improve morbility and mortality of patients, although they presented less severe lesions that those managed with CA.

Abdominal Injuries↗
PubMed2004

[Combined trauma of the abdomen and pelvis].

Experience in treatment of 164 patients with combined trauma of abdomen and pelvis is analyzed. Mean age of the patients was 40.1+/-17 years, 94 patients were male, 70 -- female. ISS was 28.6+/-11 points. Lethality was 44.5%, during first day -- 61.6%. High lethality may be associated with mistakes in surgical and traumatological policy. Abdominal surgery was performed in 64 (39%) patients, only in 24 (14.6%) of them laparotomy was curative, the rest 40 (85.4%) patients underwent diagnostic laparotomy. It is demonstrated that diagnostic laparotomy has negative influence on prognosis of combined trauma of the abdomen and pelvis. Adequate traumatological policy has also great influence on lethality, particularly during the first day. Overall lethality of patients with rotary-vertical instability of the pelvis was lower in the group with fixation of the pelvis than in conservatively treated patients (41.7 and 56.6%). Lethality during day 1 in patients with fixed pelvis was 0, without fixation of the pelvis -- 82%. It is concluded that verified indications for laparotomy and active traumatological policy improve treatment results in patients with combined trauma of abdomen and pelvis.

Abdominal Injuries↗
PubMed1991

[Spontaneous hematoma of the sheath of the rectus muscles of the abdomen. Experience in primary care].

AIM: Presentation of 3 cases of spontaneous hamatoma of the sheath of the rectus muscles in the abdomen. DESIGN: Retrospective clinical observations. LOCATION: Primary Care. PATIENTS: Two males (23 and 28 years old) and a woman (64 years old) who were clinically examined because the reported an acute abdominal pain. RESULTS: Clinical observations. CONCLUSIONS: We should consider the diagnosis of spontaneous hematoma of the sheath of the rectus muscles in the abdomen, differentiating it from a diagnosis of the acute abdomen.

Abdominal Muscles↗
PubMed1989

[Postpartum pleated abdomen. Clinical individualization. Surgical possibilities].

Post-partum pleated abdomen is a polymorphic combination of skin and abdominal wall lesions which warrants an illustrated classification. It is observed in small women who have delivered large babies or twins. Various anatomo-clinical forms can be distinguished, ranging from the slightly flaccid stretched abdomen to the severely and globally pleated abdomen, involving the suprapubic region as far as the epigastrium or only consisting of segmental abdominal pleats. The operative indication should be very cautiously considered especially when the abdominal pleats are not already associated with scars. There is now a wide variety of techniques ranging from simple suprapubic modelled cutaneous resection with possible translocation of the umbilicus to bi-axial cutaneous resection which is occasionally the only logical solution for severe cases of pleated excess skin.

Abdominal Muscles↗
PubMed1986

The value and cost effectiveness of abdominal roentgenograms in the evaluation of stab wounds to the abdomen.

The value of roentgenograms of the abdomen in the evaluation and management of stab wounds to the abdomen has not been well documented. This retrospective study demonstrates that the overwhelming majority of patients with injury requiring repair have normal roentgenograms. We also found that, even when abnormal, abdominal roentgenograms make a negligible contribution to the evaluation in these patients. These findings indicate that abdominal roentgenograms are not cost effective in patients with stab wounds to the abdomen and should not be obtained on a routine basis.

Abdominal Injuries↗
PubMed1979

[Blunt injuries of the abdomen in Gorenjsko during the past 3 years].

This paper concerns blunt injuries of the abdomen in Gorenjsko (a Region of SR Slovenija northern of Ljubljana) treated during the past 3 years. Of the total 131 hospitalized patients, 51 (or 43.5%) were operated on. In 5 (8,8%) an explorative lapartomy was performed in which no pathological substrate was found. The most frequent lesions were found in the spleen, liver and small intestine. The paper stresses the importance of an early and correct diagnosis of such injuries. In making the exact diagnosis aside from the physical evaluation, the most important procedure is lavagage of the abdomen which the authors used in all cases suspect for acute abdomen and obtained excellent results. In 20% of the patients surgery was performed within 2 hours of their of hospital admission. Injuries of the liver were treated with necrectomy, ligature of the bleeding vessels, suturing of the biliary canals, and establishment of drainage. Ligation of the hepatic artery and hepatic resection was performed in two cases. Injuries of the pancreas were also treated with necrectomy, hemostasis and drainage. In one case with a posttraumatic pseudocyst of the pancreas surgery was performed with an isolated intestinal loop according to Roux-Herzen. In conclusion the author insists on a prompt diagnosis in which abdominal lavage plays an important role. Using such an approach the morbidity is significantly reduced.

Abdominal Injuries↗
PubMed1995

Nonoperative management of gunshot wounds of the abdomen.

Nonoperative management of stab wounds of the abdomen is currently practiced in many trauma centers; this report examines the role of expectant management of gunshot wounds to the abdomen in a select patient population. Patients presenting to a single trauma service from 5/91 to 1/94 at Detroit Receiving Hospital with a gunshot wound (GSW) to the abdomen fulfilling the following criteria were observed: 1) single GSW to the right upper quadrant, 2) stable vital signs, 3) reliable examination with minimal abdominal tenderness and available team/operating room, and 4) minimal or no abdominal tenderness. There were 12 patients fulfilling the study criteria; all were successfully observed. One nontherapeutic laparotomy was done due to abdominal tenderness. The role of expectant therapy of abdominal gunshot wounds is cautiously advanced. With appropriate criteria, this technique appears safe and efficacious.

Abdominal Injuries↗
PubMed1995

Burst abdomen and incisional hernia after major gastrointestinal operations--comparison of three closure techniques.

OBJECTIVE: To compare the incidence of burst abdomen and incisional hernia after three different techniques of closure of the abdominal wall after major gastrointestinal operations. DESIGN: Prospective, randomised, controlled trial. SETTING: University hospital, Norway. SUBJECTS: 599 adults who underwent major operations for gastrointestinal conditions between December 1990 and February 1992. INTERVENTIONS: Patients were randomised in three groups for abdominal wall closure by continuous mass polyglyconate (Maxon) double suture with loop, continuous mass polyglactin 910 (Vicryl), and interrupted polyglactin 910 (Vicryl) (layered for transverse and mass for midline incisions). MAIN OUTCOME MEASURES: Burst abdomen during the postoperative period, and incisional hernia after one year follow up. RESULTS: The incidence of wound dehiscence was 2% and of incisional hernia at one year 7%. There were no differences in the rate of dehiscence among the groups, but there were significantly more hernias in the polyglyconate group (19/164, 12%) compared with the two in which polyglactin 910 was used (16/327, 5%). Wound infections developed in 84/583 of our patients (14%) and the incidence was closely associated with emergency operations and contamination. Wound complications were not associated with the closure technique. CONCLUSIONS: Wound infection is the most important single factor in the development of burst abdomen and incisional hernia. The continuous closure technique is quicker, cheaper, and as safe as the interrupted technique.

Aged↗
PubMed1994

Plain film radiologic examination of the abdomen.

The plain film of the abdomen usually is the first radiographic examination ordered to evaluate the abdomen in the ICU patient. It is inexpensive, universally available and may be done at the bedside in the ICU. This article details and describes what to look for when interpreting a plain radiograph of the abdomen.

Abdominal Pain↗
PubMedDate not supplied

Group B streptococcal cellulitis of perineum and lower abdomen: report of one case.

This report describes a 4-week-old female baby with disseminated group B streptococcus (GBS) infection. The illness began as a swelling with violaceous hue of perineum and lower abdomen, a manifestation that may be falsely attributed to a traumatic injury. GBS septicemia, meningitis and cellulitis of lower abdomen was confirmed by cultures. This case illustrated an unusual presentation of GBS infection as cellulitis of lower abdomen. The presence of concurrent septicemia and meningitis in this case indicated that a more extensive diagnostic work-up and a more aggressive therapeutic approach are needed for young infants with cellulitis.

Ampicillin↗
PubMed1996

Hyperbaric oxygen an adjunctive treatment for delayed radiation injuries of the abdomen and pelvis.

Radiation therapy is often utilized as adjunctive or primary treatment for malignancies of the abdomen and pelvis. Radiation complications are infrequent, but can be life threatening or significantly diminish the quality of life. Radiation necrosis is an approved indication for hyperbaric oxygen (HBO2). Previous publications have reported results in treating delayed radiation injuries involving many sites. This paper reports the experience of a single physician group in treating delayed injuries of the abdomen and/or pelvis. Forty-four such patients have been treated since 1979. Of the 41 patients available for follow up, 26 have healed; 6 failed to heal; and 9 patients had an inadequate course of therapy (fewer than 20 treatments). Especially encouraging was the resolution of fistulae in six of eight patients with only three requiring surgery for closure. Overall, the success rate in patients receiving at least 20 HBO2 treatments was 81%. Hyperbaric oxygen is a useful adjunct in treatment of delayed radiation injuries of the pelvis and abdomen.

Abdominal Muscles↗
PubMed1997

[Emergency computed tomography in closed trauma of the chest and abdomen].

An analysis of using computed tomography (CT) in 152 patients with closed traumas of the chest and abdomen has shown that CT is indicated in cases of disagreements between the clinical picture and findings of the laboratory instrumental methods of examination when injuries of organs and tissues and development of early and late complications are suspected. The resolution of CT in closed trauma of the chest was at an average 97.3%, in closed trauma of the abdomen 94.9%. The possibility to perform the emergency CT in patients with a severe combined injury of the chest and abdomen during 24 hs a day allows injuries of the aorta, central and subcapsular hematomas of the liver and spleen to be diagnosed in a short time as well as the exact character of injuries of the pancreas and kidneys. CT is thought to be the method of choice for diagnosis of injuries of organs of the mediastinum and retroperitoneal space.

Abdominal Injuries↗
PubMed1998

Utility and cost-savings of diagnostic laparoscopy in low-probability gunshot wounds of the abdomen.

Gunshot wounds of the abdomen are associated with a 90% or greater incidence of intra-abdominal injury, prompting many trauma centers to routinely explore these patients via laparotomy. Increasingly, diagnostic laparoscopy has been used to evaluated the abdomen to exclude peritoneal violation by the missile. Retrospective analysis of the experience at a Level I Trauma Center with 20 isolated abdominal gunshot wound patients who did not have obvious indications for laparotomy such as peritonitis or shock is detailed. Outcome and cost analysis were compared in patients who had diagnostic laparoscopy or laparotomy. Patients who underwent diagnostic laparoscopy instead of laparotomy had a 42% reduction in operative time, a 33% reduction in hospital charges, and a reduction in hospital length of stay from an average of 3.5 days to less than one day. The only operative complication noted was in a patient who underwent laparotomy. Diagnostic laparoscopy may be used in select patients to exclude significant intra-abdominal injuries following gunshot wounds of the abdomen with reduction in health care costs and morbidity.

Abdominal Injuries↗