Podcast 681: Internal Hernias

Podcast 681: Internal Hernias

Contributor: Adam Barkin, MD

Educational Pearls:

  • Internal hernias, when bowel herniates through iatrogenic or congenital defect in mesentery, represent 1-6% of all small bowel obstructions
  • Mortality of strangulated internal hernias is over 50% due to bowel necrosis and sepsis
  • Intermittent symptoms presenting with nausea, vomiting, abdominal pain, abdominal distension
  • Increased risk in patients with gastric bypass, liver transplant, or laparascopic surgery
  • CT is very >90% sensitivity and specific in diagnosing SBO due to internal hernia
    • Mesenteric swirl is a classic radiology finding
  • Treatment with immediate surgical consultation for possible OR bowel decompression
  • Start on broad spectrum antibiotics with any signs of sepsis

References

Lanzetta MM, Masserelli A, Addeo G, et al. Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings. Acta Biomed. 2019;90(5-S):20-37. Published 2019 Apr 24. doi:10.23750/abm.v90i5-S.8344

Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 2006;186(3):703-717. doi:10.2214/AJR.05.0644

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Donate to EMM today!



Jaksot(1145)

Podcast 767: Transaminitis and Rhabdomyolysis

Podcast 767: Transaminitis and Rhabdomyolysis

Contributor: Sam Killian, MD Educational Pearls: Transaminitis refers to the elevation of transaminases, enzymes of the liver (AST and ALT) Elevation of ALT is relatively specific to the liver, but A...

28 Maalis 20223min

Podcast 766: Truth about Tramadol

Podcast 766: Truth about Tramadol

Contributor: Aaron Lessen, MD Educational Pearls: Tramadol is often thought of as a mild-opiate to use for analgesia, but it is a more complicated drug Tramadol needs to be metabolized into an effect...

22 Maalis 20223min

Podcast 765: Phenobarbital for Alcohol Withdrawal

Podcast 765: Phenobarbital for Alcohol Withdrawal

Contributor: Aaron Lessen, MD Educational Pearls: Retrospective cohort study looked at return rate of discharged patients after receiving either phenobarbital or benzodiazepines or both in the ED for...

21 Maalis 20222min

Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Contributor: Chris Holmes, MD Educational Pearls: Many are taught that patients with cocaine chest pain should not receive beta-blockers due to unopposed alpha agonism, but is this true? 363 consecut...

15 Maalis 20223min

Podcast 763: Sternoclavicular Infection

Podcast 763: Sternoclavicular Infection

Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis can occur at any joint, including the sternoclavicular joint Sternoclavicular joint infections comprise 1% of all bone and joint inf...

14 Maalis 20223min

UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

Tune in for a double feature with our Equity, Diversity and Inclusion Award winners from this fall as Nick asks them about their backgrounds, what brought them into medicine and Emergency Medicine spe...

9 Maalis 202250min

Podcast 762: Endocarditis

Podcast 762: Endocarditis

Contributor: Jared Scott, MD Educational Pearls: Variability of organisms in infecting the myocardial valves Duke Criteria for Infective Endocarditis includes three categories that can be used to def...

8 Maalis 20225min

Podcast 761: Peritonsillar Abscess: To Stab or Not to Stab?

Podcast 761: Peritonsillar Abscess: To Stab or Not to Stab?

Contributor: Jared Scott, MD Educational Pearls: Often present with complaints of sore throat, pain with swallowing, difficulty swallowing, voice change, and possible fever Retrospective study from 2...

7 Maalis 20226min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
radio-antro
rss-duodecim-lehti
rss-ammamafia
rss-sosiopodi
utelias-mieli
ihanat-ipanat
mielipaivakirja
filocast-filosofian-perusteet
rss-bios-podcast
rss-tiedetta-vai-tarinaa