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Emergency Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Alastair Brookes, Yiu-Che Chan, Rebecca Fish, Fung Joon Foo, Aisling Hogan, Thomas Konig, Aoife Lowery, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Colin Walsh, John Wang, Ting Hway Wong
Following resuscitation, your child is more alert, what evaluations and initial management would you institute?Re-examine the infant to assess response to fluid resuscitation, capillary blood gas, send bloods for electrolytes, inflammatory markers and cross match.Pass a nasogastric tube to decompress the abdomen.Assess the abdomen for degree of distension, tenderness, peritonitis, and Dance sign (right upper quadrant mass with emptiness in the right lower quadrant). I will examine the anus to see if there is protrusion of a far-moving intussusceptum, presence of fissure, and nappy for red currant jelly stool.Start broad-spectrum antibiotics, organise an ultrasound abdomen urgently, and contact a paediatric surgeon.
Intussusception
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Victoria Lane, Brice Antao, Michael S Irish
The most common site for intussusception is ileocolic, with the ileum invaginating into the caecum or right ascending colon. The right lower quadrant may appear empty on examination (Dance sign) due to the intussuscepted mass being pulled upwards. The second most common type is ileoileocolic, and has two anatomical components; the first is ileoileal, which then invaginates into the caecum and colon and becomes ileoileocolic. Although this type can occasionally occur in the idiopathic group, 40% have a pathological lead point. Most (95%) idiopathic intussusceptions occur in the ileocolic area (ileocolic 85%, ileoileocolic 10%) and are said to have no pathological lead point. Most pathological lead points are anatomically manifested as ileoileocolic intussusceptions, with a smaller percentage being appendicocolic, caecocolic, colocolic, jejunojejunal and ileoileal.
Evaluation of lymphatic filariasis in endemic area of Brazil where mass drug administration is not required
Published in Pathogens and Global Health, 2019
Ellyda Silva, Amanda Xavier, Elis Silva, Walter Barbosa Júnior, Abraham Rocha, Vania Freitas, Paula Oliveira, Ana Maria Aguiar-Santos, Cristine Bonfim, Zulma Medeiros
Positive results in the POC-ICT were investigated using circulating microfilariae and quantified using the polycarbonate membrane filtration technique with 3-mm pores (Nucleopore®) [16,17] and by searching for the ‘filarial dance sign’ using ultrasound [18,19]. To test for CFA, the enzyme-linked immunosorbent assay (ELISA) Og4C3-ELISA (TropBio® Pty Ltd, Townsville, Queensland, Australia) [20] and AlereTM filariasis test strip (FTS) [2,21,22] were used. For IgG4 detection through ELISA, two recombinant antigens were used: Wb123 [23] and Bm14 [14,24,25].