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!



Episoder(1145)

Episode 928: Neutropenic Fever

Episode 928: Neutropenic Fever

Contributor: Taylor Lynch, MD Educational Pearls: What is neutropenic fever? Specific type of fever that is seen in cancer patients and other patients with impaired immune systems These patients a...

28 Okt 20245min

Episode 927: Functional Gallbladder Syndrome

Episode 927: Functional Gallbladder Syndrome

Contributor: Jorge Chalit-Hernandez, OMS3 Typically presents with biliary colic Right upper quadrant abdominal pain lasting more than 30 minutes and subsiding over several hours Often associate...

22 Okt 20245min

Episode 926: Supraventricular Tachycardia

Episode 926: Supraventricular Tachycardia

Contributor: Taylor Lynch MD Supraventricular tachycardias (SVTs) arise above the bundle of His The term SVT includes AV nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardi...

21 Okt 20246min

Episode 925: Table Sugar for Tongue Entrapment

Episode 925: Table Sugar for Tongue Entrapment

Contributor: Aaron Lessen, MD Educational Pearls: Pediatric case study where the child's tongue was stuck in the opening of a hard plastic drink lid Entrapment restricts circulation which causes f...

14 Okt 20241min

Episode 924: Pregnancy Cold Remedies

Episode 924: Pregnancy Cold Remedies

Contributor: Megan Hurley, MD Educational Pearls: Fevers Tylenol Up until 20 weeks NSAIDs are ok but after 20 weeks they are contraindicated Can limit the amount of amniotic fluid produced Ca...

7 Okt 20245min

Episode 923: Blunt Cerebrovascular Injury

Episode 923: Blunt Cerebrovascular Injury

Contributor: Travis Barlock MD Educational Pearls: Assessment of head and neck vascular injury due to blunt trauma Symptomatic patients require screening head and neck CT angiography EAST guid...

30 Sep 20243min

Episode 922: Chest Tube Irrigation

Episode 922: Chest Tube Irrigation

Contributor: Aaron Lessen, MD Educational Pearls: Hemothorax: blood in the pleural cavity, most commonly due to chest trauma Treatment: thoracostomy tube for blood drainage helps to avoid clott...

23 Sep 20242min

Episode 921: Pediatric Hypoglycemia

Episode 921: Pediatric Hypoglycemia

Contributor: Taylor Lynch, MD Educational Pearls: When it comes to hypoglycemia, the age dictates possible causes Neonate: Hormonal deficiency Congenital Adrenal Hyperplasia (21-hydroxylase de...

22 Sep 20244min

Populært innen Vitenskap

fastlegen
smart-forklart
tingenes-tilstand
jss
sinnsyn
rekommandert
villmarksliv
rss-rekommandert
forskningno
tomprat-med-gunnar-tjomlid
vett-og-vitenskap-med-gaute-einevoll
fjellsportpodden
rss-paradigmepodden
pod-britannia
aldring-og-helse-podden
tidlose-historier
diagnose
nordnorsk-historie
nevropodden
rss-lundqvist-podden