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(1144)

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Acute mountain sickness (AMS) is the term given to what is otherwise colloquially known as altitude sickness High altitude cerebral ed...

3 Helmi 20253min

Episode 941: Rehydration in Pediatric Gastroenteritis

Episode 941: Rehydration in Pediatric Gastroenteritis

Contributor: Meghan Hurley, MD Educational Pearls: Gastroenteritis clinical diagnoses: Diarrhea with or without vomiting and fever Vomiting in the absence of diarrhea has a large list of diffe...

27 Tammi 20253min

Episode 940: Laceration Repair Methods

Episode 940: Laceration Repair Methods

Contributor: Aaron Lessen, MD Educational Pearls: If a patient sustains a cut, the provider has several options on how to close the wound. If they choose to suture the wound closed, it involves need...

20 Tammi 20252min

Episode 939: Serotonin Syndrome

Episode 939: Serotonin Syndrome

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Serotonin syndrome occurs most commonly due to the combination of monoamine oxidase inhibition with concomitant serotonergic medications...

13 Tammi 20253min

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Contributor: Aaron Lessen, MD Educational Pearls: Many patients present to the ED with elevated BP Many are referred from outpatient surgery centers or present after an elevated measurement at ho...

6 Tammi 20252min

Episode 937: Pneumomediastinum

Episode 937: Pneumomediastinum

Contributor: Megan Hurley MD Educational Pearls: What is the mediastinum? The thoracic cavity is separated into different compartments by membranes The lungs exist in their own pleural cavities, a...

30 Joulu 20245min

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Contributor: Ricky Dhaliwal MD Educational Pearls: Etomidate was previously the drug of choice for rapid sequence intubation (RSI) However, it carries a risk of adrenal insufficiency as an adver...

23 Joulu 20244min

Episode 935: Pregnancy Extremis - TOLDD

Episode 935: Pregnancy Extremis - TOLDD

Contributor: Aaron Lessen MD Educational Pearls: Pregnant patients at high risk of cardiac arrest, in cardiac arrest, or in extremis require special care A useful mnemonic to recall the appropriat...

16 Joulu 20243min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
radio-antro
filocast-filosofian-perusteet
rss-laakaripodi
rss-sosiopodi
ihanat-ipanat
sotataidon-ytimessa
mielipaivakirja
rss-bios-podcast
rss-radplus
rss-opeklubi
rss-lihavuudesta-podcast