Wednesday, July 7, 2010

A case of male with abdominal pain (with CT & Pathology)

A 45-year-old male presented to his physician with the complaint of abdominal pain for 6 months. In addition to this pain, the patient related a loss of appetite with difficulty eating and frequent emesis over this period of time. In total, he had lost 20 pounds in the last 2 months, which was attributed to eating less. On physical examination, the patient’s abdomen was distended, with decreased bowel sounds. An abdominal X-ray (not shown) showed dilated loops of small intestine; however, no free air was present. An abdominal CT scan (Figure 1) was performed and revealed thickening of the terminal ileal wall and a mass in the ileocecal mesentery.

The patient was taken to surgery and right hemicolectomy was performed. On gross examination (Figure 2), there was a 7.5 cm tumor that circumferentially involved the intestinal wall and extended into the surrounding mesentery. The small intestinal mucosa overlying the mass was ulcerated.

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ABC of Burns (ABC series)

Burns are one of the most devastating conditions encountered in medicine. The injuries affect people of all ages, both physically and psychologically, in the developed and the developing world. The correct management of burns needs a skilled multidisciplinary approach and this ABC provides an overview of the most important aspects of burn injuries for healthcare professionals.
This ABC book offers a comprehensive yet accessible review of burn management. It introduces the range of burns that a GP may become involved in treating or having treated at hospital. From explanations of how burns happen, through to first aid applications, pre-hospital treatment, dressings, resuscitation and the management of deep dermal burns.
It also looks at the subsequent management of burns through hyperalimentation and microbiological management, reconstruction and rehabilitation.
A significant contribution to an important area of care: burns are the second most common cause of accidental death in children in the UK. Early treatment of burns is essential to avoid disablement: impact on lungs, infection and later need for plastic surgery can all be reduced by appropriate assessment and prompt treatment.
Includes contributions from the UK, USA and Australia, and has a chaper on international disasters.


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Tear of Medial Cruciate Ligament

These are ultrasound images of the right knee joint following a motorcycle accident. There is a curvilinear echogenic structure within the medial part of the right knee joint cavity. Diagnosis: traumatic rupture of the distal insertion of the medial cruciate ligament, which now floats within the fluid distended (possible hemorrhagic) joint space.

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