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!



Avsnitt(1145)

Podcast #220: A-Fib Cardioversion

Podcast #220: A-Fib Cardioversion

Author: Aaron Lessen, M.D. Educational Pearls Atrial fibrillation is common. One of the best treatments for a fib is cardioversion back into sinus rhythm. Cardioversion may increase stroke risk if A-...

23 Juni 20172min

Podcast #219: History of Sepsis

Podcast #219: History of Sepsis

Author: Chris Holmes, M.D. Educational Pearls "Sepo' is a term from Homer (author of The Iliad and The Odyssey), and means "I rot". Hippocrates in 400 BC identified sepsis as a "dangerous decay withi...

21 Juni 20176min

Podcast #218: Estimating Pediatric Weight

Podcast #218: Estimating Pediatric Weight

Author: Aaron Lessen, M.D. Educational Pearls Asking parents and Broselow Tape are common options for estimating pediatric weight. Equipment sizes should not be adjusted for under/overweight kids bas...

19 Juni 20172min

Podcast #217: Designer Drugs

Podcast #217: Designer Drugs

Author: John Winkler, M.D. Educational Pearls: Designer, or "synthetic" drugs include bath salts, synthetic THC, and many others. Many of these drugs are originally manufactured in China and are ship...

17 Juni 20173min

Podcast #216: Roller Coasters and Kidney Stones

Podcast #216: Roller Coasters and Kidney Stones

Author: Aaron Lessen, M.D. Educational Pearls: Anecdotal evidence suggests that roller coasters may help with kidney stones. A recent study used a model of a kidney and ureter with different sized s...

13 Juni 20171min

Opioid MIniseries Part IV: Harm Reduction

Opioid MIniseries Part IV: Harm Reduction

PRACTICE RECOMMENDATIONS 1. Patients who abuse opioids should be managed without judgement; addiction is a medical condition and not a moral failing. Caregivers should endeavor to meet patients "where...

8 Juni 201748min

Opioid Miniseries Part III: Alternative to Opioids

Opioid Miniseries Part III: Alternative to Opioids

PRACTICE RECOMMENDATIONS 1. All emergency departments should implement ALTO programs and provide opioid-free pain treatment pathways for the following conditions: a. Acute on chronic opioid-tolerant r...

8 Juni 201749min

Opioid Miniseries Part II: Limiting Opioids in the Emergency Department

Opioid Miniseries Part II: Limiting Opioids in the Emergency Department

RACTICE RECOMMENDATIONS 1. Opioids are inherently dangerous, highly addictive drugs with significant abuse potential, numerous side effects, lethality in overdose, rapid development of tolerance, and ...

8 Juni 20171h 8min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
dumforklarat
pojkmottagningen
rss-vetenskapsradion-2
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
sexet
halsorevolutionen
rss-spraket
medicinvetarna
rss-experimentet
vetenskapsradion
paranormalt-med-caroline-giertz
4health-med-anna-sparre
rss-tidslinjen-podcast