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)

Podcast #262: Pertussis

Podcast #262: Pertussis

Author: Julian Orenstein, M.D. Educational Pearls Colorado has a high population of unvaccinated children, and is at increased risk for pertussis outbreaks. The causative organism is Bordetella pertu...

23 Okt 20174min

Deep Dive #7: Domestic Violence

Deep Dive #7: Domestic Violence

Authors: Katie Sprinkel, MD Emergency Medicine Physician SANE Medical Director, Medical Center of Aurora Amy Ferrin, Senior Deputy District Attorney County Court Supervisor Office of the District A...

16 Okt 201737min

Podcast #261: Icatibant

Podcast #261: Icatibant

Author: Aaron Lessen, M.D. Educational Pearls Icatibant was introduced to treat ACE-inhibitor induced angioendema. This type of angioedema is refractory to epinephrine and antihistamines, and is like...

13 Okt 20172min

Podcast #260: Preoxygenation

Podcast #260: Preoxygenation

Author: David Rosenberg, M.D. Educational Pearls Preoxygenation is done before rapid sequence intubation, and should be done even if SaO2 is at 100%. Preoxygenation is done to fill the lungs with oxy...

11 Okt 20172min

Podcast #259: Transient Ischemic Attacks

Podcast #259: Transient Ischemic Attacks

Podcast #259: TIA Author: Peter Bakes, M.D. Educational Pearls A TIA is defined as focal neurological deficit that resolves within 24 hours and has negative imaging. The etiology is a transient throm...

9 Okt 20177min

Podcast #258: REBOA

Podcast #258: REBOA

Author: Dylan Luyten, M.D. Educational Pearls Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Exsanguination is a major cause of mortality in trauma One temporizing technique to bu...

6 Okt 20173min

Podcast #257: Strangulation

Podcast #257: Strangulation

Educational Pearls Strangulation is common in cases of domestic violence and sexual assault, and it is associated with higher mortality People who have been strangled have a higher rate of stroke due...

4 Okt 20174min

Podcast #256: Fentanyl Ingestion

Podcast #256: Fentanyl Ingestion

Authors: Don Stader, M.D & Rachael Duncan, PharmD BCPS BCCCP Educational Pearls Fentanyl patches may be abused in many ways, including changing the patches more frequently, chewing them, extracting t...

2 Okt 20175min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
rss-rekommandert
sinnsyn
forskningno
villmarksliv
nordnorsk-historie
fjellsportpodden
smart-forklart
rss-paradigmepodden
aldring-og-helse-podden
diagnose
pod-britannia
rss-overskuddsliv
abid-nadia-skyld-og-skam
tomprat-med-gunnar-tjomlid