...RATE OF DEVELOPMENT OF INCISIONAL HERNIA ONE YEAR AFTER URGENT MIDLINE LAPAROTOMY Abd-El-Aal A. Saleem1, Hassan A. Abdallah1, Osama A. Abdul Raheem1, Mohamed Yousef A1. 1 Department of General Surgery, Faculty of Medicine, Aswan University, Aswan, Egypt. Correspondence to Abd-El-Aal A. Saleem, MD, Department of General Surgery, Faculty of Medicine, Aswan University, Aswan, Egypt. Tel.: 0934608283 - 01001203179 e-mail:dr.abdelaal@yahoo.com ABSTRACT OBJECTIVE To determine the rate of development of incisional hernia six months and one year follow up in patients suffering from peritonitis ( potentially septic wounds) and other patients suffering...
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...DEFINITION OF PROCEDURE EXPLORATORY LAPAROTOMY A laparotomy is a large incision made into the abdomen. Exploratory laparotomy is used to visualize and examine the structures inside of the abdominal cavity. Exploratory laparotomy is a method of abdominal exploration, a diagnostic tool that allows physicians to examine the abdominal organs. The procedure may be recommended for a patient who has abdominal pain of unknown origin or who has sustained an injury to the abdomen. Laparotomy may be performed to determine the cause of a patient's symptoms or to establish the extent of a disease. Advameg, Inc. (2012). Laparotomy, exploratory. Encyclopedia of Surgery. Retrieved November 18, 2012, from http://www.surgeryencyclopedia.com/La-Pa/Laparotomy-Exploratory.html#b A 'look-see' operation usually of the peritoneal cavity, in which the surgeon examines all surfaces for lesions– e.g., abscesses and tumor nodules; during exploratory laparotomy, the operator may biopsy the tissue or obtain peritoneal washings from which a specimen for cytology is processed. Indications: Surgical staging of regional malignancy–e.g., ovarian cancer, complications, adhesion formation. Farlex, Inc. (2012). Exploratory laparotomy. The Free Dictionary. http://medical-dictionary.thefreedictionary.com/exploratory+laparotomy By definition, an exploratory laparotomy is a laparotomy performed with the objective of obtaining information that is not available...
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...A CASE STUDY ON EXPLORATORY LAPAROTOMY WITH ADHESOLIYSIS, RIGHT HEMICOLECTOMY WITH PRIMARY END-TO-END ANASTOMOSIS ________________________________ In Partial Fulfillment of the Course Requirement In Surgical Nursing ________________________________ Presented to: The Faculty of Cebu Doctors’ University College of Nursing _____________________________ Submitted by: xxxxxxxxxxxxxxxxxxxxxxx Phi 2nd generation Class 2009 30 September 2008 TABLE OF CONTENTS I. Introduction ……………………………………………………………………. 3 II. Objectives ……………………………………………………………………... 5 III. Nursing Assessment……………………………………………………………. 8 A. Personal History Patient’s Profile Family and Individual Information Level of Growth and Development Normal Development at Particular Stage The Ill Person at Particular Stage of Patient B. Diagnostic Results…………………………………………………... 16 C. Present Profile of Functional Health Patterns ……………………. 17 Health Perception / Health Management Pattern Nutritional – Metabolic Pattern Elimination Pattern Activity / Exercise Pattern Cognitive / Perceptual Pattern Rest / Sleep Pattern Self – perception Pattern Role Relationship Pattern Sexuality – Reproductive Pattern Coping – Stress Tolerance Pattern Value –...
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...Ovarian Cancer Ovarian cancer is one of the most under-detected types of cancers in existence because many of the symptoms are not noticeable until the later stages of the disease. These symptoms typically follow a pattern that helps determine whether or not a woman has ovarian cancer. The symptoms are “frequent bloating, pain in your belly or pelvis, trouble eating, or feeling full quickly, urinary problems, such as an urgent need to urinate or urinating more often than usual, fatigue, indigestion, pain with intercourse, constipation, and menstrual cycle changes.” For women who have ovarian cancer, the symptoms follow three common attributes: “they start suddenly, they feel different than your normal digestive or menstrual problems, and they happen almost every day and don’t go away.” However, another problem with the symptoms of ovarian cancer is that there are some women that just naturally have them, and that makes it very difficult to determine whether or not they have cancer (http://www.webmd.com/ovarian-cancer/guide/ovarian-cancer-symptoms - Symptoms). The risk factors that are associated with ovarian cancer are not absolute. However, like in any type of disease or infection, the more risk factors that a person has, the more likely they are to become disease-ridden. The risk factors of ovarian cancer can be very complex, but simplify as a person gets older. One factor is gene mutations within families. Most of the mutations come from families that have a prominent number...
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...follow commands and respond appropriately. Is neurological disability a central phenomenon from shock, or is there a direct spinal cord injury? The patient must always be adequately exposed to evaluate all injuries, don’t over look the axial, back, gluteal cleft, and perineum. Patients with penetrating abdominal injuries are best served by antibiotic therapy prior to operative intervention. Initial therapy should be broad, with coverage of both gram-positive and gram negative organisms. Current practice guidelines advise broad spectrum antibiotics prior to incision and throughout operation -tentanus toxoid upon admission The care of the trauma patient does not end with intraoperative repair of injuries. The hypothermic, coagulopathic laparotomy patient is prone to numerous postoperative complications: Expect...
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...never ordered to call him if things changed with Mrs. Hall. An autopsy was done and it showed that a sponge had been left in her abdominal cavity but it did not cause her death. Mrs. Hall's husband filed a malpractice/wrongful death case against Dr. Hilbun stating that he failed to follow-up after the operation and give post-operation instructions to the nursing staff. At the trial, Hall's husband called Dr. Hoerr as a witness but was disqualified because he was not familiar with the local standard of care, only the national one. After reading about this case, I believe that Dr. Hilbun was at fault for the four D's of negligence. The first D is duty, which there was a patient and physician relationship. He did perform an exploratory laparotomy on her for a bowel obstruction after she came in for abdominal pain. The second would be derelict, which means the patient would have to prove the physician failed to comply with...
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...BSBMED301B: Assignment 1 What you have to do Using the learning resource provided answer the following questions: Question 1 Using your knowledge of word components, give the correct medical term for each of the definitions below. Definition Medical Term 1. rectal hernia Rectocele 2. excision of the stomach Gastrectomy 3. inflammation of the kidney Nephritis 4. enlargement of the liver Hepatomegaly 5. incision to remove a stone Lithotomy 6. fixation of the intestine Enteropexy 7. artificial opening in the colon Colostomy 8. incision into the abdomen Laparotomy 9. absence of one or both testes Anarchism 10. rupture of the uterus Hysterorrhexis 11. excision of the prostate gland Prostatectomy 12. visual examination of the vagina Colposcopy 13. surgical repair of a testicle Orchiopexy 14. discharge of milk Galactorrhea 15. difficult labour or delivery Dystocia 16. suture of the tongue Glossorrhaphy 17. surgical puncture of the abdomen Abdominocentesis 18. pus in the urine Pyuria 19. pertaining to above the kidney Suprarenal 20. narrowing of the urethra Urethral Stricture Question 2 Give the meaning of each of the abbreviations below. Abbreviation Medical Meaning 1. LUQ Left upper quadrant 2. GI Gastrointestinal 3. OGD Oesophago-gastro duedenoscopy 4. CVS Chorionic villus sampling 5. STD Sexually transmitted disease 6. IUD Intrauterine device 7. TURP Transurethral resection of the prostate 8. DRE Digital rectal...
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...Basatiny, & Abdella, 2015). (3) Mesocolic hernias ICD 10 - K46.0 Mesocolic hernias are the third differential diagnosis, which is an uncommon small bowel obstruction seen in many preterm males, with a mortality rate of 50% if not treated in a timely manner (Licciardello et al., 2014). According to Licciardello et al (2014), the presenting symptoms are intermittent colicky, abdominal pain and vomiting. The pertinent findings were abdominal pain, vomiting and colicky. The pertinent negative is it is seen in many preterm males. J. T’s symptoms are similar to a mesocolic hernia, such as his abdominal pain, vomiting and colicky. The CT scan is considered the first line imaging technique to use if suspected and treatment choice is surgery, laparotomy (Licciardello et al., 2014). ...
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...Appendicitis From Wikipedia, the free encyclopedia | Appendicitis is a medical emergency characterized by inflammation of the appendix, many cases of which require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of the risk of rupture leading to infection and inflammation of the intestinal lining (peritoneum) and eventual sepsis, clinically known as peritonitis which can lead to circulatory shock. Reginald Fitz first described acute and chronic appendicitis in 1886, and it has been recognized as one of the most common causes of severe acute abdominal pain worldwide. A correctly diagnosed non-acute form of appendicitis is known as "rumbling appendicitis". Appendicitis is most common between the ages of 5 and 40; the median age is 28. It tends to affect males, those in lower income groups, and, for unknown reasons, people living in rural areas. The term "pseudoappendicitis" is used to describe a condition mimicking appendicitis. It can be associated with Yersinia enterocolitica. acute appendicitis appendicitis of acute onset, requiring prompt surgery, and usually marked by pain in the right lower abdominal quadrant, referred rebound tenderness, overlying muscle spasm, and cutaneous hyperesthesia. chronic appendicitis 1. that characterized by fibrotic thickening of the organ wall due to previous acute inflammation. 2. formerly, chronic or recurrent pain in the appendiceal area, without evidence of acute...
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...Description of Incident: During my rotation in the post anesthesia unit (PACU) I was caring for a patient who emerged from robotic assisted total laparoscopic hysterectomy, bilateral salpingo-oophorectomy and a laparotomy. This patient developed signs and symptoms of respiratory distress and was on a respiratory ventilator on bi-pap mode. During the care of the patient, the physician ordered a hemoglobin and hematocrit lab. I was attempting to draw a blood sample, when we noticed the test tube was damaged. I went to get another test tube to draw the blood sample. I retrieved the test tube and successfully drew the blood sample for the requested lab. The nurse pointed out that I left the patient’s side rail down and she stated this put...
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...the symptoms with low salt healthy balance diet, regular non-strenuous exercise, and relaxation techniques. This year, she had a unplanned pregnancy and was miscarriage due to foetus no heart beat. IMMUNISATIONS LT was born in Singapore and has completed all the compulsory/ recommended/neccessary National Childhood and Adolescent Immunisation, ---- Family Health Service, Ministry of Health (MOH), Singapore. (provide website) She also completed other Optional Vaccinations as follow: Flu vaccines prior to her year-end overseas vacation trips, HPV vaccine Tetanus vaccine Chicken pox vaccine HOSPITALISATIONS (List date or age, reason for admission and any sequelae) At age of 9, 1984 Perforated appendicitis underwent laparotomy appendectomy. Post-operative complication of complete wound dehiscence down to subcutaneous layer, treated with intravenous antibiotic and wound care in hospital setting. At age of 27, 2002 Threatening abortion At age of 38, 2012 Endometrisis underwent Breast...
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...General Surgery is a surgical specialty that focuses on abdominal contents including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland (depending on the availability of head and neck surgery specialists). They also deal with diseases involving the skin, breast, soft tissue, and hernias. Services Offered : Trauma surgery – Often they are the first port of call to critically ill or gravely injured patients, and must perform a variety of procedures to stabilize such patients, such as intubation, burr hole, cricothyroidotomy, and emergency laparotomy or thoracotomy to stanch bleeding. Laparoscopic surgery – This is a relatively new specialty dealing with minimal access techniques using cameras and small instruments inserted through 0.3 to 1 cm incisions. Robotic General surgeons that are trained today are expected to be proficient in laparoscopic procedures. Colorectal surgery – General surgeons treat a wide variety of major and minor colon and rectal diseases including inflammatory bowel diseases (such as ulcerative colitis or Crohn's disease), diverticulitis, colon and rectal cancer, gastrointestinal bleeding and hemorrhoids. Breast surgery – General surgeons perform a majority of all non-cosmetic breast surgery from lumpectomy to mastectomy, especially pertaining to the evaluation and diagnosis, of breast cancer. Vascular surgery – General surgeons can perform vascular surgery if they receive special training...
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...Marshall-Marchetti-Krantz Procedure is one of the two primary surgeries to treat stress incontinence. The other procedure is retropubic urethropexy or Burch procedure. The difference between these two procedures is that the Burch procedure uses sutures to attach the urethra and bladder to muscle tissue in the pelvic area. The Marshall-Marchetti-Krantz procedure uses sutures to attach these organs to the pelvic cartilage. The Marshall-Marchetti-Krantz procedure is performed to reinforce the bladder neck, which prevents unintentional urine loss also known as urinary stress incontinence. Stress incontinence is the unintentional loss of urine prompted by a physical movement or activity, such as coughing, sneezing or lifting heavy items, which puts pressure or stress on the bladder. Stress incontinence is also the most frequent for of incontinence and is most frequent in women, especially those who are past menopause. (Blaivas) It is reported that stress incontinence is more frequent in women because of the female anatomy, and the pelvic muscles weaken with age as well as childbirth because it places burden on the muscles. Even though it is more prone in women, male incontinence also occurs and is primarily caused in response to blockage in the prostate or after prostate surgery. To better understand urinary stress incontinence, it is important to understand the vital organs that are in the urinary system, such as: two kidneys, two ureters, a urinary bladder and the...
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...disease (rare) Special considerations: In order to plan an operation for a patient with colon cancer, the surgeon must have a thorough understanding of the tumor's location in the bowel, the stage of the cancer, and the patient's physiologic status. ( answer those with pt. info) Pharmacology: Preop- 4 L of polyethylene glycol solution is given to the patient to be taken over 2-3 hours in the afternoon of the day before the procedure. A sodium phosphate enema is given on the night before the operation. Two doses of metronidazole and neomycin sulfate are given after the lavage preparation on the day before surgery. An intravenous (IV) second-generation cephalosporin is administered within 1 hour before incision. Instrumentation: standard laparotomy set Scalpel with No. 11 and No. 15 blades Curved and straight artery forceps A pair of toothed thumb forceps A pair of nontoothed forceps Allis forceps Noncrushing intestinal clamps Hemostatic clips or ligatures Handheld ultrasonic dissector (if...
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...The toughest situation that I have faced occurred during a clinical rotation. The morning began like any other. I set up for a hand debridement, and had some time before the case started. Suddenly, the nursing director burst through the door and urgently told me and my preceptor, Austin to come quick. Initially, I thought that another room needed help, but it turned out that a car crash victim was being rushed to surgery. Austin started telling me to grab extra gloves and gowns and instrument sets for an exploratory laparotomy. We hastily scrubbed in and started setting up as the surgeon, anesthesiologist, and others rushed into the room with a man not much older than me. I was standing there in disbelief at what was happening. I saw bags of blood ready for transfusion. It seemed like...
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