Pneumoperitoneum and its related abdominal pain are usually a surgical emergency that dictates ruling out perforated viscus. There multiple causes of pneumoperitoneum, which nonsurgical; we report case patient after salpingo-oophorectomy for ectopic pregnancy presenting in the postoperative period week with excess pneumoperitoneum due to sexual intercourse, cunnilingus, use air insufflating vibrator.

Patients who develop a cardiovascular implantable electronic device (CIED) infection requiring extraction may have risk factors that make them prone to developing another of the reimplanted CIED. However, rate second repeat in such patients is unknown and important clinical implications.We retrospectively reviewed all at our institution from January 2001 October 2012 underwent CIED for an then required reimplantation. We incidence due infection. Clinical parameters time were retrieved.There...

A 27-year-old pregnant female presented to the emergency department with pelvic pain and vaginal bleeding. At time of diagnosis, she had an ectopic pregnancy in right cornua 4 cm size a human chorionic gonadotropin (hCG) value 14,438 international units per mL. The was initially managed by intramuscular methotrexate. However, after 10 days, despite hCG drop 409 mL, indication that methotrexate working, patient subsequent rupture hemoperitoneum necessitating exploratory laparotomy abdominal...

Never events (NE) and hospital-acquired conditions (HAC) after surgery have been designated as quality metrics in health-care by the Centres for Medicare Medicaid Services (CMS).The Nationwide Inpatient Sample (NIS) database 2002-2012 was used to identify patientswho underwent kidney transplant. Multivariate analysis using logistic regression outcomes risk factors of HAC NE transplantation; however, we were limited a retrospective missing some important variables specified transplant, such...

We herein report a case of 55-year-old female with an unusual post-operative kratom withdrawal. The patient's withdrawal symptoms subsequently contributed to complications and admission the intensive care unit. Features this are discussed, alongside management implications supplementation unregulated herbal medications.

Amyand's hernia is an unusual condition characterized by the presence of a normal or inflamed appendix located within inguinal hernia. We present rare situation wherein 56-year-old male patient presented with incarcerated in right He was emergently taken to operating room, diagnostic laparoscopy changed open, due cecum and terminal ileum. The segment had be resected primary anastomosis. purulent contents were washed out, defect left unrepaired abscess canal.

A Spigelian hernia is a very rare hernia, making up approximately 0.1% of all abdominal wall hernias. This goes through defect in the fascia which part transversus abdominis aponeurosis lateral to rectus muscle, often at level arcuate line, where widest and weakest. We present case 77-year-old female with no past surgical history who presented our teaching hospital high-grade small bowel obstruction secondary an incarcerated hernia. She was taken operating room for laparotomy portion...

A 38-year-old female presented with an acute flare of ulcerative colitis. She was started on prednisone and mesalamine. Within 24 hours initiating mesalamine, she developed sinus bradycardia. After holding the heart rate returned to normal within five days. Our case illustrates third described case, our knowledge, severe bradycardia secondary

Schwannomas are tumors comprised of schwann cells the peripheral nervous system and infrequently present in gastrointestinal tract. Transverse colon schwannomas an even more rare subtype schwannomas. This study presents case a transverse schwannoma, addition to presenting literature review.

Overwhelming post-splenectomy infection (OPSI) syndrome is a rare and well-known entity that rapidly progresses with poor outcomes. Two patients underwent splenectomy after trauma later presented flu-like symptoms thrombocytopenia, which then progressed to fulminant sepsis death. The first patient had 20 days post-splenectomy, the second 15 years before presentation. Both expired within 24 hours of onset symptoms. Even no specific criteria for diagnosis, prompt identification overwhelming...

At our center, over 200 patients undergo minimally invasive repairs of inguinal hernias every year using a laparoscope and robotic-assisted technique. In three who underwent procedure for uncomplicated indirect hernia, the postoperative course was complicated with bleeding required an exploratory laparotomy. Post-procedure, developed tachycardia hypotension drop in hemoglobin, which surgical re-exploration emergent fashion. The factors leading to were analyzed are reported herein increase...

We aimed to report the rate and short-term outcomes of patients undergoing re-operation following kidney transplant in U.S.The Nationwide Inpatient Sample (NIS) database was used examine clinical data during same hospitalization from 2002-2012. Multivariate regression analysis performed compare with without re-operation.We sampled a total 35 058 who underwent transplant. Of these, 770 (2.2%) had hospitalization. Re-operation associated significant increase mortality (30.4% vs. 3%; adjusted...

An 81-year-old woman presented with multiple episodes of loose bowel movements. CT scan the abdomen and pelvis revealed pneumatosis cystoides intestinalis asymptomatic emphysematous cystitis. The patient had an extensive workup no obvious identified pathology to explain diffuse small bladder. Her symptoms improved symptomatic management, empirical antibiotics, surgical intervention.

Background Numerous classifications exist for intertrochanteric (IT) fractures, commonly focused on stability. However, the currently utilized Arbeitsgemeinschaft Osteosynthesefragen and Orthopaedic Trauma Association (AO/OTA) classification has limitations in identifying irreducible fractures. This study aims to answer following questions: does fracture stability imply irreducibility; which fragments complicate reduction; reduction techniques should be employed? Materials methods...

Transdiaphragmatic hernia via the central tendon in pericardium is a rare entity. Most often, these hernias are acquired and related to iatrogenic creation of transdiaphragmatic-pericardial defect. We would like present case 62-year-old male who presented with acute chest pain was diagnosed have on computed tomography. He has history cardiac intervention an abdominal approach 12 years earlier. A segment jejunum found strangulated used DaVinci Xi® (Intuitive Surgical, Sunnyvale, CA) robot...

An 83-year-old woman with oral corticosteroid use for chronic autoimmune conditions presented abdominal pain and constipation the previous seven days. CT of abdomen pelvis revealed a large fecaloma diffuse pneumatosis involving retroperitoneum, subcutaneous tissue, mediastinum. emergent exploratory laparotomy perforation rectum below peritoneal reflection into retroperitoneum. end-colostomy Hartmann's operation was then performed intra-operatively. Despite operative treatment complicated by...

We present three cases where an inflamed incarcerated appendix was in a femoral, inguinal, and umbilical hernia. All patients underwent appendectomy laparoscopically. The hernias two of the (femoral inguinal) were left unrepaired as primary goal to relieve patients' symptoms achieve source control. hernia repaired primarily patient with intraoperatively. At months follow-up, none had clinically visible