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General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
A 6-week-old male infant is brought to A+E with a 1-week history of projectile vomiting. You have been asked to see him. How would you manage him?I would take a history. Was the child feeding normally up to now? Is the vomit milky or bilious? Is he hungry after feeding? Weight loss? Family history of similar problems?I would perform an examination. Dehydration? Abdominal distension? Palpable lump (olive) in RUQ (easier to feel when feeding)?
Practice exam I: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
Patients with ovarian cancer may present as an emergency with a variety of symptoms. They can present with abdominal pain due to torsion or ischaemia of the cancer (1). Patients may complain of rapid abdominal distension, which may be due to the tumour growth or to associated ascites (1). Distension is also associated with acute and subacute bowel obstruction, which may be due to pressure of the tumour or infiltration of the bowel itself (1). Increasing intra-abdominal pressure may cause respiratory compromise, with breathlessness and prolapse (2). The ureters can be involved either by infiltration or via direct pressure, and this may present as renal failure (1).
Tools for Effective Nursing in the Care of the Infertile Patient
Published in Steven R. Bayer, Michael M. Alper, Alan S. Penzias, The Boston IVF Handbook of Infertility, 2017
Sharon Edwards, Susan Gordon-Pinnell, Kristin MacCutcheon
Triage: The nurse plays an important role in the triage of medical and emotional issues that need to be addressed during the course of treatment and brought to the attention of the physician. For example, ectopic pregnancies can be more common in the infertile population who undergo IVF treatment. A patient who calls with a menses that is lighter than usual, has bleeding at an anticipated time of the menstrual cycles, has abnormal rising human chorionic gonadotropin (hCG) titers, or complains of pain should be considered at risk of having an ectopic pregnancy. Ovarian hyperstimulation syndrome (OHSS) complicates any fertility treatment but is more common in the patient undergoing IVF and being triggered with hCG. Symptoms can occur any time from the time of the egg retrieval until the pregnancy test. Initial symptoms include abdominal distention and pain. Symptoms of more advanced OHSS include shortness of breath, nausea and vomiting, and severe pain—these patients need to be brought in for evaluation expeditiously. These are examples of why REI nurses must have a thorough understanding of complications and know the signs and symptoms of many nuances presented by patients. Since the nurse is in frequent contact with the patient, the nurse is the person fielding these important calls—if not properly triaged, these patients can be at risk for serious consequences.
Case report and review of literature: immature teratoma with islets of a yolk-sac tumour: could it be omitted for years?
Published in Journal of Obstetrics and Gynaecology, 2023
Žana Stanić, Zlatko Hrgović, Rajko Fureš, Anis Cerovac
Among the ovarian germ cell neoplasms, the teratomas are the most common ones, comprising about 10–20% of all ovarian malignancies in women younger than 20 years (Iavazzo et al.2017). Mixed malignant germ cell tumours represent a combination of two or more malignant components, observed in about 8% of all cases of malignant ovarian germ cell tumours (MOGCT). The most common combination is that of dysgerminoma with the yolk sac tumour (YST) (Rana et al.2016). The YST component indicates higher malignant potential of the lesion, mandating more precautious therapeutical approach. Immature teratomas (IMTs) usually affect girls during the first two decades of life (Der and Seidu 2019). The most common symptoms are unspecific: pain, abdominal distension and masses (Wang et al.2017). On radiographs, magnetic resonance imaging (MRI) and ultrasound scans, IMTs are typically larger (14–25 cm) than mature cystic teratomas (usually up to 7, 5 cm). In addition, they may have a prominent solid component in the cystic elements (Nishida et al.2014).
Clinical and Pathological Features of Congenital Hepatic Hemangioma in Children: A Retrospective Analysis
Published in Fetal and Pediatric Pathology, 2023
Rong Wen, Zheng-Zhen Zhou, Wei-Jian Chen
In mesenchymal hamartomas of the liver (MHL), the pathogenesis is not yet clear, but abnormal development of the portal compartment is currently an accepted theory. Serum AFP may also be elevated accordingly [16]. It usually occurs in children before the age of two years. The typical clinical symptoms are abdominal distension or abdominal masses that are painless. Imaging features depend on the changes in interstitial components. Enhanced CT scans may reveal multiple small cystic masses. Under the microscope, various mesenchymal components such as dilated lymphatics, blood vessels, irregular bile ducts, mucosal matrix and collagen fibers can be seen as hyperplasia. Scattered or accumulated liver cells may also be seen. Invagination of blood vessels into the bile ducts, seen with NICH, is absent. MHL does not become malignant or recur after complete resection.
Nutritional Counseling Protocol for Colorectal Cancer Patients after Surgery Improves Outcome
Published in Nutrition and Cancer, 2021
Isabelle R. Novelli, Bruno A. D. Araújo, Laura F. Grandisoli, Elianete C. G. Furtado, Evelyn K. N. Aguchiku, Marina C. G. Bertocco, Tassiane P. Sudbrak, Isabel C. de Araújo, Ana C. F. Bosko, Nágila R. T. Damasceno
At baseline, the most common adverse symptoms were abdominal distension, abdominal pain, and stiffness, observed in more than 50% of subjects. The frequency of these symptoms decreased throughout the intervention, showing significantly lower values at 3-month PO. The reports of constipation also decreased, and only 5% of patients maintained this symptom after 3-month PO. Inappetence, nausea, diarrhea, and other symptoms maintained similar frequency compared to baseline (p > 0.05) (Table 2). Analysis of the frequency of symptoms according to the main types of surgery performed (right colectomy, left colectomy, total colectomy, or rectosigmoidectomy) found that the surgical technique used did not impact any of the monitored symptoms. Over the analyzed periods, the frequency of diarrhea decreased in patients undergoing right colectomy (baseline = 3; 1-month PO = 1; 3-months PO = 0 individuals), with a similar profile in the cases of right and total colectomy. However, in rectosigmoidectomy diarrhea frequencies increased one month after surgery (Baseline = 2; 1-month PO = 4; 3-months PO = 2 individuals). The frequency of bloating and abdominal distension, according to type of surgery decreased over the period evaluated in this surgical technique.