会阴外伤致膀胱异物残留1例

1临床资料患者男性,26岁,矿工,因不慎被外物刺伤会阴部60余天,曾先后到多家医院诊治无效后,于2009-07-05来我院就诊,查会阴部见一约1.0cm长创口,肛门指检可触及直肠前壁约2.0cm×0.5cm索条状硬物,有明显触痛,局部黏膜无破损,经膀胱镜检查,发现膀胱内游离异物,膀胱三角区有异物显露,无活动。     

阑尾穿孔致腹膜炎、肠梗阻1例

病例介绍：患者男性，33岁。因左中下腹阵发性绞痛伴恶心、呕吐两天来我院就诊。患者两天前出现左中腹部阵发性绞痛伴恶心、呕吐，无腹泻、发热及畏寒等，自服药物无明显好转。次日又出现左下腹疼痛及尿痛，在当地医院就诊，检查B超未见泌尿系统异常，考虑“尿路结石”给予对症治疗，因治疗无好转而来我院求治。     

膀胱异物漏诊1例分析

患者 ,男 ,2 7岁 ,战士 ,因反复尿频、尿急、尿痛、终末血尿 11个月入院。患者于 11个月前因车祸致脑挫裂伤、硬膜下血肿手术治疗。当时曾留置导尿 ,并在第 3天因躁动暴力将导尿管拔出 ,接着再次留置导尿管时出现血尿 ,共留置导尿管 12ｄ后拔管。拔管 7ｄ后渐出现上述症状 ,抗感染治疗可好转。此后症状反复 ,曾先后 3次住内科治疗均未治愈 ,体温一直正常 ,尿常规示 :红细胞 +～ ,白细胞 +～ ;多次尿培养示 :大肠埃希菌生长 ;两次尿ＰＣＲ ＴＢ ＤＮＡ(— ) ;2次Ｂ超未见异常。诊断 :尿路感染。予抗感染、碱化尿液治疗多个疗程 ,时间长达 1…     

巨大卵巢囊肿并结核性腹膜炎1例

1 临床资料患者女,20岁。左上腹痛1月于1990年4月12日就诊。检查:体温37.0℃,脉搏80次/min,血压12.5/8kPa,体重60kg。心肺正常,腹膨隆,肝、脾触诊不满意,腹部触诊有揉面感。X 线检查双肺正常,双横膈于前四肋平,明显升高。实验室检查:血、便、尿常规正常,     

肛缘刺伤致腹膜炎1例

1病例报告患者男,15岁。因不慎跌倒被木头刺伤臀部,膝胸位肛检见肛门皱皮肌稍紊乱,钟点位7点处距肛门约1cm处,有一长约2cm,深约10cm伤口,有活动性出血,肛门指检未见异常,伤道及直肠检查未见损伤。行伤口清创引流术。术后12h患者出现腹痛、腹胀,伴发热。查体：体温38．4℃,右下腹压痛、反跳痛,     

灌肠致穿孔1例报告

灌肠是临床上较常用的诊断及治疗手段之一。如操作不当可致严重并发症。现将灌肠致穿孔 1例报告如下 :患者 ,男 ,60岁 ,因急需做腹部摄片 ,于当日 6h/Am到某院行清洁灌肠。护士采用硬塑灌肠管常规操作。在操作中 ,患者诉腹部痛较剧 ,故停止灌肠 ,仍不见好转。 2h后 ,自行缓解 ,当日 7h/Pm来我院急诊室就诊 ,因腹痛 ,停止排气 ,排便 13h诊断肠梗阻、肠穿孔收入普外科住院治疗。查体 :全腹平 ,下腹压痛仅跳痛 ,肌紧张阳性。全腹鼓音 ,移动性浊音阳性。肠鸣音每 1次 /min。经腹透确诊肠穿孔 ,于入院后次日 4h/Pm在全麻下进行直肠乙状结肠交界…     

急性心梗并室间隔穿孔1例

１病历简介 患者,男,６５岁,以心肌梗塞在当地医院治疗２周后来院就诊。主诉：胸闷、憋气、恶心。查体：心率绝对不整,第一心音强弱不一,脉搏短细,心界向左侧扩大,呼吸２０次／ｍｉｎ,血压 １４／１２ｋＰａ,肝脾未触及,腹水征（一）,双下肢无浮肿。心电图报告：（１）快速房颤;（２）ＱＲＳ低电压,急件广泛前壁及下壁心梗、梗塞周围阻滞。心肌酶谱：ＣＰＫ３５９、ＣＤＨ１６７２、ＧＯＴ４２Ｕ／Ｌ、二维超声左室长轴图测左房３３ｍｍ、左室６４ｍｍ、主动脉３４ｍｍ、右室３１ｍｍ、室间隔中下部变薄,厚约３ｍｍ,且呈弧形…     

两种术式治疗急性化脓性腹膜炎伴阑尾穿孔效果对比观察

目的:对比观察腹腔镜辅助小切口阑尾切除术与经腹直肌剖腹探查切口阑尾切除术,治疗急性化脓性腹膜炎伴阑尾穿孔的效果。方法:选择急性化脓性腹膜炎伴阑尾穿孔40例,随机分为观察组和对照组各20例。观察组采用腹腔镜辅助小切口阑尾切除术,对照组采用经腹直肌剖腹探查切口阑尾切除术。比较两组手术时间、术后排气时间、术后抗生素使用时间、住院时间和术后并发症发生情况等。结果:两组手术成功率均为100%。观察组术后排气时间、住院时间和术后抗生素使用时间均显著短于对照组(P<0.05),手术时间两组比较,差异不显著(P>0.05)。两组术后均未发生肠漏、门静脉炎等严重并发症,观察组并发症发生率显著少于对照组(P<0.05)。结论:腹腔镜辅助小切口阑尾切除术治疗急性化脓性腹膜炎伴阑尾穿孔的效果,优于经腹直肌剖腹探查切口阑尾切除术。     

Absorbed dose resulting from a specially designed computed tomography technique for examination of the urinary bladder

The absorbed spatial dose distribution resulting from a specially designed CT protocol for examination of the urinary bladder has been investigated with TLD rods in a body phantom containing tissue equivalent material. The CT examination consisted of scout view and both pre- and postcontrast scan series with 5 mm slice thickness and 5 mm unscanned intervals between successive scans. Cross-sectional dose distribution for one scan in the plane of the ovaries was measured as well as the dose profile for one scan along a line through the ovary parallel to the axis of rotation. Based on these measurements, the dose resulting from the whole CT examination was calculated, both with contiguous and noncontiguous scans. The ovarian dose was calculated for different positions of the ovaries in relation to the scanned area. The absorbed dose varied between 8.3 mGy and 9.7 mGy with the actual technique used. When contiguous scans with the same thickness were taken, the ovarian dose increased with a factor from 1.7 to 1.9. The dose resulting from the CT protocol of the urinary bladder was of the same magnitude as absorbed dose resulting from urography. When the diagnostic gain from a precise definition of tumor extent was taken into account, the dose resulting from the CT protocol was judged acceptable.     

Gd-BOPTA-enhanced MR cholangiography findings in gall bladder perforation

Gall bladder perforation is a rare condition which is associated with significant mortality and morbidity. Here, we report a case of spontaneous gall bladder perforation following acute calculous cholecystitis with pericholecystic abscess identified on Gd-BOPTA-enhanced MR cholangiography (MRC) prior to laparoscopic surgery. The gall bladder perforation was confirmed via surgery with unremarkable recovery. To the best of our knowledge, this is the first report of Gd-BOPTA-enhanced MRC for this purpose.     

Effectiveness of plain radiography in diagnosing hollow viscus perforation: study of 1,723 patients of perforation peritonitis

Gastrointestinal perforations remain the most common cause of surgical pneumoperitoneum since time immemorial. The aim of this study was to find out the effectiveness of plain radiography in diagnosing hollow viscous perforation. A prospective analysis of a total of 1,723 patients of perforation peritonitis between January 2009 and June 2011, confirmed by exploratory laparotomy, was worked out in the study. All these patients had undergone either an upright chest or erect abdominal or both radiographs before undergoing operative procedure. Pneumoperitoneum was evaluated, and the findings were compared with that of exploratory laparotomy. Out of the 1,723 patients of documented perforation on intraoperative finding, 1,537 patients showed pneumoperitoneum on preoperative plain radiography. The overall positivity rate of plain radiography in detecting pneumoperitoneum was 89.20%. The positivity rate was highest for stomach and duodenal perforation (94.19%) and the least for appendicular perforation (7.69%) with highly significant difference (p value, <0.001). In developing world, where there is limited availability of resources and overburden of patients, imposing a limitation in adapting advanced radiological technique as a first line of investigation, plain radiography may be considered as a valuable screening tool in detecting pneumoperitoneum with high positivity rate.     

Angiography in urinary bladder tuberculosis.

Angiography was performed in 6 cases of bacteriologically and microscopically verified tuberculosis of the urinary bladder. As a rule, general or locally accentuated hypervascularization in the bladder wall could be demonstrated in the arterial phase but no venous abnormalities were observed. The circulation time was usually not changed. Thus the angiographic appearances were non-specific. Angiographically it is impossible to differentiate between tuberculous cystitis, cystitis of other genesis or even tumour of the bladder.