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 # 430: Humeral IO

Podcast # 430: Humeral IO

Author: Aaron Lessen, MD Educational Pearls: Choose the longest needle for the humeral IO Internally rotate and adduct the patients hand (resting on umbilicus) for best access to the site Aim 1 cm su...

30 Jan 20193min

Podcast # 429: Oldschool Syphilis Treatment

Podcast # 429: Oldschool Syphilis Treatment

Author: Chris Holmes, MD Educational Pearls: In WWI, the 2nd leading cause of soldier disability were STDs. An early treatment of syphilis included topical and inhaled mercury Bloodletting, vitriol, ...

28 Jan 20194min

Podcast # 428: Severe Hypothyroidism

Podcast # 428: Severe Hypothyroidism

Author: Gretchen Hinson, MD Educational Pearls: Clinical manifestations of severe hypothyroidism may include: Pale, cool, diaphoretic skin Myxedema is the non-pitting edema seen in hypothyroidism Hy...

27 Jan 20193min

Podcast # 427: Cookie Dough is Delicious

Podcast # 427: Cookie Dough is Delicious

Author: Eric Miller, MD Educational Pearls: Recent CDC statement warms against consumption of cookie dough Two common ingredients can pose risk: eggs and flour Flour in dough is a raw agricultural ...

24 Jan 20192min

Podcast # 426: Ho Ho - Oh No!

Podcast # 426: Ho Ho - Oh No!

Author: Katrina Iverson, MD Educational Pearls: The winter holiday months present a unique picture of patient presentations to the emergency department Some of the unique presentations include: Chi...

22 Jan 20192min

Podcast # 425: Oseltamivir Efficacy in Children

Podcast # 425: Oseltamivir Efficacy in Children

Author: Aaron Lessen, MD Educational Pearls: Recent meta-analysis reviewed efficacy oseltamivir (Tamiflu) in pediatric populations treated for influenza, showing an 18 hour reduction in duration of i...

18 Jan 20193min

Podcast # 424: Hunting for Measles

Podcast # 424: Hunting for Measles

Author: Mike Hunt, MD Educational Pearls: Measles is highly contagious and successfully infects 90% of those at risk exposed to the virus. 10 day prodrome where patients are asymptomatic. 3 day perio...

16 Jan 20194min

Podcast # 423: Blunt Cardiac Injuries

Podcast # 423: Blunt Cardiac Injuries

Author: Mike Hunt, MD Educational Pearls: Blunt cardiac injuries most commonly occur in motor vehicle collisions, auto-pedestrian collisions, and from sports injuries The more anterior right ventri...

14 Jan 20194min

Populært innen Vitenskap

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